In some cases, however, a healthcare provider may need to take a sample from those areas and send it to a laboratory for testing. In more severe cases, when thrush has spread to the esophagus, a diagnostic procedure called endoscopy may be needed.
At-Home Testing
Although it doesn’t always cause symptoms, thrush can cause symptoms such as a white coating on the inside of the mouth and throat, a cottony sensation in the mouth, soreness, and/or loss of taste.
Certain self-checks are said to aid in diagnosis. However, there’s no scientific support for them. They include a practice called “the candida spit test,” which involves spitting into a clear glass of water immediately after waking. Proponents suggest that saliva that sinks to the bottom of the glass—or turns the surrounding water cloudy—may signal the presence of thrush, but this has not been scientifically proven to be a reliable test.
Lab Tests
Your healthcare provider may be able to diagnose thrush with a simple visual examination of your mouth and throat.
They may need to take a sample of one of the affected areas in your mouth (also known as lesions) for a microscopic examination. These samples typically involve a gentle, painless scraping.
Throat Culture
In some cases, healthcare providers may use a throat culture to help diagnose thrush. This procedure involves using a cotton swab to collect a sample from the back of the throat. While the swabbing of your throat may be briefly uncomfortable, it’s unlikely to cause pain.
The sample is sent to a laboratory, where it’s placed in a special environment to promote cell growth and analyzed.
Other Tests
Because certain underlying health issues, like diabetes or a weak immune system, can increase the risk of thrush, your healthcare provider may perform further testing to see if you have any risk factors.
Imaging Tests
To diagnose thrush in the esophagus, healthcare providers use a diagnostic procedure called endoscopy. This is an invasive technique that involves examining the esophagus, stomach, and upper part of the small intestine with an endoscope: a flexible, lighted tube equipped with a camera at the end.
There was an error. Please try again.
What to Expect
Often done by a gastroenterologist, endoscopy is generally performed in a hospital or an outpatient center. The procedure usually takes between 15 and 30 minutes.
To help you relax during your endoscopy, you’ll most likely receive a light sedative (often given through an intravenous needle in your arm). Since the sedatives administered prior to endoscopy take up to 24 hours to wear off, you’ll need to arrange for a ride home from the hospital or outpatient center.
For your endoscopy, you’ll lie on your side on an exam table while your healthcare provider passes the endoscope down your esophagus and into your stomach. During the procedure, the small camera at the end of the endoscope will transmit a video image to a monitor. This allows your healthcare provider to obtain a close examination of the lining of your upper GI tract.
At this time, your healthcare provider may also perform a biopsy (i.e., the removal of cells or tissue). If you have a biopsy, a pathologist will examine the sampled tissue to check for disease.
Some people experience symptoms such as bloating or nausea for a short time after an endoscopy. In addition, you may have a sore throat for one or two days.
Some results from your endoscopy may be available right away, and biopsy results will take a few days longer.
Potential Risks
While endoscopy is a safe procedure, it does carry the risk of the following complications:
Bleeding from the site where your healthcare provider took the tissue samplesPerforation in the lining of your upper GI tractAn abnormal reaction to the sedative, including breathing or heart problems
If you experience any of the following issues after undergoing endoscopy, seek immediate medical attention:
Chest painDifficulty breathingProblems swallowing, or throat pain that gets worseVomitingPain in your abdomen that gets worseBloody or black, tar-colored stoolFever
Differential Diagnosis
In some cases, thrush may cause symptoms similar to those associated with other illnesses. For that reason, your healthcare provider may consider the following conditions when evaluating you or your child for a possible case of thrush:
Aphthous ulcers Pediatric cytomegalovirus infection Pediatric enteroviral infections Pediatric esophagitis Pediatric pharyngitis
Other conditions with similar symptoms include:
Angular cheilitisAtrophic vaginitisLichen planusOral leukoplakiaStomatitisSquamous cell carcinoma
