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What Causes White-coated Tongue With Dryness While Treating Helicobacter Pylori Infection?

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Posted on Wed, 29 Jun 2016
Question: Hi, i was in treatment for Helycobacter Pilori with Metrogdinazol and Roxitromicina. The last day of the treatment i got my tongue white, rough and dry, very unconfortable, my GP gave me Miconazol (2 weeks) without sucess. I have changed to Mycostatin without sucesss. I am very worried because i don't know what happen with my tongue. The doctor told me that i should be patient and now he says that it is strange that the treatment doesn't work.
doctor
Answered by Dr. Panagiotis Zografakis (15 minutes later)
Brief Answer:
perhaps you should escalate the treatment

Detailed Answer:
Hello,

since you've already done a treatment course without success, perhaps you should move on to the next step which consists of a 7-14 days treatment with fluconazole 100-200mg/day (I would vote for 200mg). Sometimes stopping the offending agent (the antibiotic) is enough to make the yeast infection resolve but it seems that yours is a persistent one.

Make sure you don't use any antibiotic or corticosteroids (even inhaled ones) or if you do please let me know so that I can give you more specific instructions about how to handle them.

I hope it helps!
Kind regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (12 minutes later)
Should i ask my GP if he can take some sample of my tongue to verify that i have fungus? Do you think they are fungus according to the image or can be another pathology?
Thanks
doctor
Answered by Dr. Panagiotis Zografakis (5 minutes later)
Brief Answer:
no need for tests at this point

Detailed Answer:
You're welcome!

There is no need to do more tests at this point. What you have to make sure is that you don't also have symptoms from lower gastrointestinal structures like the esophagus (may feel like the food is stuck somewhere behind your chest). In such cases the treatment will have to last for some weeks and an upper gastrointestinal endoscopy would be required.

Otherwise fluconazole should suffice. The image and the connection to antibiotic treatment make candidiasis the most likely diagnosis.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (1 hour later)
Thank you very much. I don't have any other symptom and i eat what i want without any problem and my stomach is ok now. It is only the tongue. You have explained me everything very well. They made me a endoscopy one year ago when they discover the helicobacter.
My last question is, sometimes happen that this candidiasis is so persistant and takes so long time to cure it?
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
it commonly resolves soon

Detailed Answer:
When the yeast infection is contained within the oropharyngeal area it usually takes a few days. Sometimes only local treatment is enough. For the more persistent or severe cases fluconazole by mouth (pills) is given. If fluconazole is not enough then there are other much more expensive options but I doubt you'll have to take them.

Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3814 Questions

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What Causes White-coated Tongue With Dryness While Treating Helicobacter Pylori Infection?

Brief Answer: perhaps you should escalate the treatment Detailed Answer: Hello, since you've already done a treatment course without success, perhaps you should move on to the next step which consists of a 7-14 days treatment with fluconazole 100-200mg/day (I would vote for 200mg). Sometimes stopping the offending agent (the antibiotic) is enough to make the yeast infection resolve but it seems that yours is a persistent one. Make sure you don't use any antibiotic or corticosteroids (even inhaled ones) or if you do please let me know so that I can give you more specific instructions about how to handle them. I hope it helps! Kind regards!