What not to do when thrush persists

Women are being advised against rushing out to self-treat their thrush with anti-fungal creams if it is persistent or recurring.

Women with recurrent thrush are being urged not to self-medicate with topical treatments without ruling out a more sinister cause.

The advice is one of many new recommendations announced by advocacy group Choosing Wisely Australia.

Many women with recurrent and persistent yeast infections, commonly known as thrush, self administer anti-fungal creams that are available over the counter.

While these anti-fungal creams and tablets are the recommended treatment for thrush, medically called vulvovaginal candidasis, it's important to rule out other causes such as genital herpes or bacterial vaginosis, says Dr Graham Neilsen, president of the Australasian Chapter of Sexual Health Medicine.

"As well as the importance of ruling out other causes before commencing anti-fungal agents, inappropriate use can lead to increased fungal resistance," said Dr Neilsen.

Even though some may feel embarrassed to talk about issues affecting their sexual health, Dr Neilsen says good communication with your doctor will assure the most appropriate care.

Other Choosing Wisely recommendations, developed by Australian medical societies and colleges, warn against unnecessary genetic testing for Alzheimer's disease and coeliac disease.

Professor Jack Goldblatt from the Human Genetics Society of Australasia is concerned increased testing for the APOE gene, considered a risk of susceptibility for Alzheimer's, provides false reassurance.

He says the test only shows probability.

"If the likelihood of improved outcomes from the use of a test for the gene is extremely low, then is should not be undertaken," Prof Goldblatt advised.

Similar concerns are held among gastroenterologists in regards to testing for the coeliac gene.

Professor Anne Duggan from the Gastroenterological Society of Australia says a blood test is a sufficient first line of investigation because a coeliac gene can be found in one third of the population and a positive result doesn't mean the disease is a certainty.

Patients are also warned about the small but significant risk of undergoing too many colonoscopies.

"Surveillance colonoscopies place a significant burden on endoscopy services, so surveillance should be targeted at those who are most likely to benefit at the minimum frequency required to provide adequate protection against the development of cancer," Prof Duggan said.

Colonoscopy can have side effects including bleeding, tears, inflammation or infection.


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Source: AAP



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