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What Is Anal Thrush or Candidas?


Here’s what you need to know to identify, treat, and prevent anal yeast infections.

Candidiasis, more commonly known as a yeast infection or thrush, is caused by the fungus Candida and is not just limited to the vagina. Anal thrush is not uncommon among sexually active gay men and immunocompromised patients like people living with HIV. While often easily treated with over-the-counter medications or a simple visit to the doctor, the infection can lead to more serious medical conditions if left untreated.

Yeast infections are caused when there is an overgrowth of the fungus Candida. The fungus is commonly found in the body’s gastrointestinal system and elsewhere in places that are dark and moist like the mouth and genitals. Our immune systems are usually able to keep the fungus in check, though. When there’s an imbalance between the Candida and bacteria the body uses to fight the fungus, a yeast infection can occur.

It is also possible to become infected with anal thrush via other means. These include having unprotected anal sex or engaging in analingus with a partner who has anal thrush, or using unclean sex toys contaminated with the fungus. Poor hygiene, obesity, diabetes, antibiotics, and a weakened immune system are also common contributors to anal thrush.

The most common initial symptom of anal thrush is an intense and persistent itching called pruritus ani. Other symptoms include a burning sensation; red, irritated, and inflamed skin around the anus; bleeding; or an unpleasant smelling discharge. The symptoms are usually intense at first, but then taper off.

People living with HIV and other severely immunocompromised individuals are particularly susceptible to anal thrush. In such cases, anal thrush can spread to the skin, esophagus, and lungs, and can further spread to other organs if it enters the bloodstream. The presence of Candida “represents 10% of nosocomial infections in hospitalized patients and is associated with mortality described to be as high as 40 percent” according to one study by researchers in France.

Anal thrush will sometimes go away on its own and can be often treated with over-the-counter medication, but a doctor can better diagnose your condition and prescribe an appropriate form of treatment. Most cases of anal thrush can be treated and resolved with a one-time dose of fluconazole. More severe cases may require multiple doses along with additional ointments and creams.

There are several over-the-counter treatments for yeast infections in the form of anti-fungal creams, ointments, and suppositories that are effective against anal thrush. Some brand name medications include Monistat (miconazole), Terconazole (terazol), Lotrimin (clotrimazole), and Butoconazole (gynazole).

While anal thrush is not entirely preventable, there are some good steps to take to lessen your chances of becoming infected:

  • Wear breathable cotton underwear.
  • Thoroughly wash your genitals and anus after working out or swimming.
  • Stay healthy with good body weight and healthy diet
  • Avoid using scented products to clean your anus.
  • Wear a condom during anal sex and a dental dam during analingus.

Anal thrush is a not uncommon yeast infection that can be quickly identified and easily treated. While it can often go away on its own or by using common over-the-counter medication, a visit to the doctor is in order, especially for people living with HIV whose immune systems are compromised.

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