Mouth Ulcers and Asthma Inhalers: How Are They Connected?

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Asthma inhalers are commonly used by asthma sufferers for intake of asthma relief medications. The inhaler is basically a device that dispenses medicines taken by breathing in or inhaling. As the main treatment device for asthma, most asthma sufferers find themselves using this device several times a week, if not a day.

Many patients have reported mouth ulcers caused by the use of asthma inhalers to their physicians. Mouth ulcers are clearly formed, oval or round sores that form on the inner side of the mouth. They are typically painful and also known as aphthous ulcers. The main connection between mouth ulcers and asthma inhalers is the development of thrush as a side effect of using inhaled corticosteroids (steroids).

Mouth Ulcer Side Effects from Inhaled Corticosteroids

One of the most effective treatments for asthma is the use of medications that prevent and control asthma over the long-term by reducing inflammation of airways and cutting down production of mucus. Inhaled corticosteroids are one of these standard medical treatments involving steroids. Functioning similarly to cortisol, a hormone produced by the adrenal glands, corticosteroids help decrease inflammation in the airways and prevent asthma attacks and symptoms. Often abbreviated as ‘steroids,’ these are not the drugs abused by several athletes for synthetic male hormone production and performance enhancement.

Formation of mouth ulcers and asthma inhalers can actually be connected. Usage of inhaled steroids in the oral cavity can diminish the regular bacteria dwelling in the mouth and throat. This creates an environment that promotes yeast growth, and inhaled corticosteroids side effects (ICS) can develop. The risks of contracting this condition are typically very small, but this may be the reason behind your development of mouth ulcers.

One of the local adverse effects of ICS is thrush, or oral candidiasis. Up to one-third of all ICS sufferers develop this side effect. Thrush is oral infection from a species of candida fungi. It causes appearance of thick cream or white-coloured deposits on the mucosal membranes that line the inside of the mouth. Such infected mucosa in the mouth will appear inflamed, red and even partly raised. Inhaled steroids don’t cause infection by fungi in the lungs.

Treatment of Thrush from Use of Asthma Inhalers

Side effects from use of inhaled steroids are a point of concern as such medications are used for long periods of time by patients.

  • Thrush can be treated with use of oral or topical anti-fungals like nystatin.

  • Lowering dosage of corticosteroids being taken from the asthma inhaler can also help. This must be done only after instructions from a certified doctor are received.

  • Use of a spacer device with a metered dose inhaler can help prevent and treat thrush. This is a plastic tube attached to the inhaler. It holds the medication’s mist for a long enough time, allowing you to inhale it steadily and slowly into the lungs. In some cases, changing the technique used for inhalation can help get rid of thrush and prevent further occurence. Very often, a lot of the asthma medication ends up in your mouth rather than the small airways within the lungs. That’s where it’s actually needed for effective asthma treatment.

  • Also, ensure that you rinse your mouth using water after every inhalation. What this does is help remove any steroids that might have settled down in the oral membranes.This reduces chances of infection developing in the mouth. Bear in mind that the inhaler itself must be kept dry at all times. Do not wash any portion of the mouthpiece or inhaler.

In all cases, seek medical advice from your physician before initiating treatment of your mouth ulcers from asthma inhalers. An effective pill may be prescribed by your doctor for such conditions.

References Asthma Treatment Options: ICS Side Effects of Steroid Treatments for Asthma

WebMD: Asthma Control with Anti Inflammatory Drugs