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Grzybica przyczyną owrzodzeń w jamie ustnej

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Zakażenia grzybicze w obrębie jamy ustnej są wywoływane przez drożdżaki z rodzaju Candida. W przebiegu kandydozy jamy ustnej może dojść do powstania nadżerek i owrzodzeń na błonach śluzowych jamy ustnej oraz pęknięć w kącikach ust. Jakie są przyczyny tego schorzenia i jak się je leczy?

Przyczyny grzybicy jamy ustnej

Grzyby z rodzaju Candida u znacznej części populacji stanowią element naturalnej flory jamy ustnej. Objawy chorobowe rozwijają się w następstwie zachwiania równowagi fizjologicznej w jamie ustnej, którego przyczyną może być obniżenie odporności, niektóre rodzaje terapii oraz czynniki środowiskowe.

Grzybica jamy ustnej a leki

Na grzybicę jamy ustnej narażone są osoby stosujące długotrwałą antybiotykoterapię lub leki sterydowe, zwłaszcza wziewne oraz podawane miejscowo na błonę śluzową jamy ustnej. Ryzyko kandydozy występuje również u osób w immunosupresji oraz u pacjentów poddawanych radioterapii. Czynnikiem predysponującym do choroby może być również długotrwałe stosowanie antykoncepcji hormonalnej.

Choroby współistniejące a ryzyko grzybicy jamy ustnej

Kandydoza jamy ustnej występuje częściej u osób z upośledzeniem funkcji układu odpornościowego, np. z powodu zakażenia wirusem HIV.

Grzybica jamy ustnej może częściej występować również u osób cierpiących na cukrzycę oraz schorzenia związane z zaburzeniami hormonalnymi (niedoczynność nadnerczy i tarczycy, nadczynność przytarczyc).

Inne przyczyny grzybicy jamy ustnej

Ryzyko wystąpienia kandydozy jest większe u osób zaniedbujących higienę jamy ustnej, palących papierosy, a także u osób noszących aparaty ortodontyczne i protezy, które mogą powodować mikrouszkodzenia błon śluzowych. Przyczyną choroby może być również nadmierne korzystanie z przeciwbakteryjnych płynów do płukania ust, prowadzące do zaburzenia równowagi flory bakteryjnej.

Czynnikiem ryzyka drożdżycy jest również niewłaściwa dieta, uboga w witaminy i mikroelementy (zwłaszcza kwas foliowy, żelazo, witaminy z grupy B), lub nadmiernie obfitująca w węglowodany.

Objawy kandydozy jamy ustnej

Do objawów grzybicy jamy ustnej należą: suchość w jamie ustnej, biały nalot na języku i podniebieniu, ból języka, dziąseł lub podniebienia, nieprzyjemny zapach z ust, trudności z przełykaniem śliny.

Zmiany chorobowe mogą przejawiać się jako miękkie białawe lub żółte wykwity (tzw. pleśniawki), bolesne żywoczerwone plamy lub trudne do usunięcia białawe grudki i płytki, a także nadżerki i owrzodzenia w obrębie błon śluzowych.

W niektórych odmianach kandydozy może również dojść do wytworzenia twardniejących guzków i grudek na podniebieniu i języku oraz do pęknięć i krwawień w kącikach ust.

Zmiany chorobowe w jamie ustnej mogą powodować zaburzenia odczuwania smaku, a w konsekwencji spadek apetytu u pacjenta.

Leczenie kandydozy jamy ustnej

Terapia kandydozy jamy ustnej powinna się rozpocząć od badania mykologicznego z antymykogramem. Leczenie przeciwgrzybicze w większości przypadków ma charakter miejscowy. Dodatkowo zaleca się płukanki z chlorheksydyną do płukania jamy ustnej. Terapię ogólną wdraża się u pacjentów, którzy nie reagują na leczenie miejscowe lub u których występuje ciężki przebieg choroby.

Duże znaczenie w zwalczaniu kandydozy ma właściwa higiena jamy ustnej, eliminacja miejscowych czynników drażniących, suplementacja w celu wyrównania niedoborów.

Źródło:

B. Petkowicz, M. Skiba-Tatarska, J. Wysokińska-Muszczuk, „Kandydoza jamy ustnej”, „Gerontologia Polska” 2006, 14(4): 160-164.

Przeczytaj także: Jak grzyby wpływają na proces leczenia uszkodzeń w jelitach u osób z chorobą Leśniowskiego-Crohna?

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