Intestinal candidiasis is a disease caused by conditionally pathogenic fungi of the genus Candida. Conditionally pathogenic they are called because micromycetes are unicellular microorganisms found in the intestine in more than 50% (meaning people who did not go to doctors with symptoms of candidiasis) of healthy people.
Causes of development and clinical manifestations
Candida intestinal pathogens are Candida fungi. They may belong to different species (Candida glabrata, Candida albicans , Candida parapsilosis, Candida tropicalis, Candida lusitaniae, Candida dubliniensis, Candida krusei), but normally there are very few of them in the human body. The growth of colonies is hampered by bifidobacteria, Escherichia coli, lactobacilli, enterococci, and the mucin glycoprotein of the epithelial cell wall that covers the mucous membrane. The latter prevents the attachment of the microbe to epithelial cells.
Candida has no significant effect on the host organism, and only when the body’s defenses are inhibited, the fungus’s immunity decreases, they begin to actively proliferate and seize various parts of the intestine. Both the normal intestinal microflora and barrier compounds contribute to antifungal resistance (resistance), and by suppressing or reducing the activity of one of these factors, the body's defenses weaken and yeast fungi penetrate into the internal environment.
What leads to a decrease in antifungal resistance? Different conditions and diseases:
- oncological diseases (antitumor therapy suppresses the immune system and inhibits the protective forces of the intestinal epithelial cover);
- physiological immunodeficiencies (age and conditions: early childhood and advanced age, stressful conditions and pregnancy, immunodeficiency);
- endocrinological disorders (decompensated diabetes);
- acquired immunodeficiency syndrome;
- allergic and autoimmune diseases;
- any diseases that cause or against which there is a violation of the absorption and digestion of food (these processes are accompanied by the active growth of colonies of microorganisms);
- organ transplantation
The most common causes are antibiotic therapy and unbalanced nutrition. The balance of the microbial biocenosis of the intestine is easily disturbed by the long-term intake of antibacterial drugs. Similarly, an insufficient amount of protein entering the body affects the activity of phagocytes and bacteria.
Deterioration of appetite, fatigue, bloating and heaviness in the stomach, white, resembling cottage cheese, blotches in the stool, pain in the stomach, empty stool and a disturbing feeling of incomplete bowel emptying - this is not a complete list of clinical manifestations of intestinal candidiasis. As you can see, they do not have absolute specificity, so it is worthwhile to look into a doctor and undergo a full clinical and laboratory examination, after which the treatment of this rather unpleasant and dangerous disease should begin.
Diagnosis is complicated by the fact that the causative agent of candidiasis can either passively exist in the intestine or participate in the pathological process.
Often clinical and laboratory research includes:
- Endoscopic examination. It allows you to assess the condition of the mucous membrane, confirms the presence or absence of ulcers and white plaque.
- X-ray of the intestine.
- Microbiological research. Allows you to determine the species of the pathogen and select the appropriate antimycotic for treatment. Sowing feces also has diagnostic value. So, the diagnosis is confirmed. If the number of identified colonies is more than 105-106 CFU per gram.
- Histological and cytological examination. A scraping from the mucous membranes of the intestine, a gable biopsy, a brush-biopsy can reveal Candida pseudomycelium by staining the biomaterial or by treatment with chromic acid.
- Invasive, focal and non-invasive intestinal candidiasis
The clinical manifestations of intestinal candidiasis depend on the mechanism of the Candida fungus invasion into tissues. So, if the filamentous form of the fungus is not introduced into the tissue, and Candida actively reproduces in the lumen of the intestine, candidiasis is considered non-invasive . In this form of candidiasis, only abdominal and parietal digestion is violated.
Feelings of the patient:
- Itching in the anus
- Unformed chair
- Feeling of pain in the intestines
- Spastic abdominal pain
- Signs of mild intoxication
Neither dieting nor stopping antibiotic treatment brings relief. Positive dynamics can be traced only in the treatment of antimycotic drugs.
The diagnosis of invasive intestinal candidiasis is made when the fungus invades the epithelial layer and the basement membrane. It is characterized by a severe course and is accompanied by symptoms of duodenal ulcer .
Feelings of the patient:
- Abdominal pain
- Diarrhea with blood and mucus
- Subfebrile fever
- Phenomena of perianal candidodermatitis
If time does not begin the treatment of invasive candidiasis of the intestine, then it is likely to transform into systemic candidiasis with lesions of the mucous membranes of other organs.
Directions of drug treatment of intestinal candidiasis
There are several therapeutic areas according to which a treatment plan for intestinal candidiasis is worth.
- Selective intestinal decontamination, i.e. taking drugs that will eliminate the causative agent of the disease - Candida fungi.
- Treatment of major and related diseases.
- The appointment of a course of prebiotics and probiotics to restore the natural antimicrobial microflora of the intestinal mucosa.
- Diet therapy.
All antifungal (antifungal) drugs inhibit ergosterol biosynthesis of the fungal cell wall. However, some antifungal agents are absorbed in the upper intestine, and in the lumen of the colon and ileum they are not reached in sufficient concentration, and it is there that the main colonies of fungi are concentrated in intestinal candidiasis. In this regard, the reception of such antifungal drugs like ketoconazole , amphotericin B, fluconazole , itraconazole will not give effect. On the contrary, the development of toxic hepatitis and multiple side effects are possible.
Thus, non-absorbable antifungal agents should be used for treatment.
4 times a day pill (100 mg) for 7-10 days - adults.
2 times a day, 1 tablet (100 mg.) For 5-10 days.
Contraindication: hypersensitivity to the components of the drug.
|Levorin||Adults: 2–4 times a day for 10–12 days for 500,000 IU. Children (based on weight per kg): up to 2 years for 25–30,000 IU, 2–6 years for 20–25,000 IU, more than 6 years - 200-250 000 IU. 2-4 times a day. Contraindications: peptic ulcer, pancreatitis, pregnancy, age up to 2 years, renal failure.|
|Nystatin||The duration of treatment is 10-14 days. Adults: at a dose of 500 000 IU. 3-4 times a day. For children: up to a year - three times a day for ¼ tablets in a dosage of 250,000 IU., Up to 3 years - in the same dosage 3-4 times a day, older than 3 years - 4 times a day older 13 years the maximum dose of 1 000 000 IU. per day. Contraindication: idiosyncrasy. During pregnancy, the drug is allowed.|
Treatment with antifungal drugs is considered effective if the symptoms of the disease have disappeared and the data of mycological research indicate the normalization of the number of fungi. A positive result of sowing may indicate a candida carrier, which, in fact, is not a disease.
Concurrent diseases are treated in parallel. For example, ulcerative and gastroesophageal reflux diseases are treated with antisecretory drugs (lanzap, nexium) and histamine H2 receptor blockers. Helicobacter pylori therapy is carried out by amoxicillin, omeprosol. Prebiotics (the so-called stimulants of the intensive growth of normal microflora) should also be included in the diet. An excellent start will be pectin, lactulose, Eubikor - a drug rich in dietary fiber, amino acids and vitamins. Dietary fiber, without undergoing changes, enters the colon and is metabolized by microbiota. The latter stimulate the formation of mucus and cells, where bifidobacteria and lactobacilli feel comfortable.
During the treatment of intestinal candidiasis, experts recommend to stop eating foods that are rich in simple carbohydrates: milk, berries, sugar, confectionery, kvass, beer, honey.
For those who, for any reason, do not accept drug treatment, we offer several recipes of traditional medicine. As we always remind: self-treatment is not safe, consult your doctor.
Boil oats (5 tbsp. Grains 15 tbsp. Of water) for three hours, filter the resulting broth and ingest 3 times a day, 100 g each. in the form of heat. The duration of treatment is up to 4 months.
In ¾ glass of brandy add 3 tbsp. salt, stir until salt crystals dissolve. After half an hour, dilute the tincture with boiling water from a ratio of 1: 3. The resulting drug is drunk once a day, adding to 2 tbsp. tinctures 6 tbsp. water, 1 hour before meals. The duration of treatment is 25 days.
If neither treatment with folk remedies, nor medication treatment gives results, then it makes sense to clarify the diagnosis and be examined in a specialized mycological clinic. The lack of treatment is fraught with damage to parenchymal organs and the development of intestinal perforation and fungal sepsis.