The source of infection in the human body is in the intestines and mouth. Infection of the esophagus occurs in ascending and descending ways, respectively. Fungi multiply and show their pathogenic properties with reduced resistance of the body, immunodeficiency or other favorable conditions for them.
The population of the Candida genus in the esophagus is increasing, which leads to the development of candidiasis.
From the external environment the causative agent penetrates into the body:
- When in contact with a patient or carrier,
- When eating contaminated food,
- When using contaminated household items and personal care products.
Factors provoking the development of esophageal candidiasis:
- Injury to the esophagus or its damage by sharp objects,
- Long-term treatment with corticosteroids,
- Long-term antibiotic therapy,
- Long antacid therapy,
- Intoxication of various genesis,
- Smoking and alcoholism,
- Violation of motility of the digestive tract,
- The lack of protein in the body after prolonged diets,
- Parenteral nutrition,
- Organ transplantation,
- Hypofunction of the adrenal glands or parathyroid glands,
- Immune pathologies - AIDS,
- Consequences of chemotherapy,
- Severe chronic infections - tuberculosis.
Candida penetrates the tissues of the esophagus of a weakened organism, actively multiplies and forms pseudomycelia. Histological examination of samples taken for biopsy confirms the diagnosis of candidal esophagitis after detection of mycelial filaments. Individual colonies of candida occur on the esophagus mucosa in normal or indicate carrier of the fungus. Such conditions do not require treatment.
Candidiasis of the esophagus - one of the most difficult diagnosed diseases of the digestive system. Almost half of the patients have no pathology.
The main symptoms of esophageal candidiasis are:
- Pain in the upper abdomen,
- Dysphagia - a violation of swallowing,
- Decrease or lack of appetite,
- Pain when swallowing,
- Discomfort behind the sternum,
- Nausea and vomiting with the release of films,
- Increased body temperature,
- Liquid stool with mucus.
The intensity of pain when swallowing is different: from slight to severe, preventing normal intake of food and water. Such complications lead to dehydration of the body.
At the initial stage of the infection, the infection affects only the mucous membrane, and then penetrates into deeper tissues and structures. The surface of the mucous membrane is covered with characteristic films that can completely block the lumen of the esophagus.
Complications of esophageal candidiasis (which will, if not cure and start the disease at all):
- Necrosis of tissues,
- Stricture of the esophagus.
- Bleeding from blood vessels.
Esophagoscopy is the main diagnostic method of esophageal candidiasis. Esophagoscopy is performed by all patients complaining of difficulties and pain when swallowing food. Endoscopic examination allows us to examine the mucosa of the esophagus with the help of special optical equipment.
Endoscopic signs of esophageal candidiasis:
- The vulnerability of the mucosal surface upon contact,
- Swelling and congestion,
- Fibrous raids on the mucosa.
Catarrhal endophagitis is characterized by mild edema of the mucous membrane, diffuse hyperemia, bleeding during contact, the formation of a whitish coating on the surface.
Fibrinous esophalitis is manifested by loose plaques in the form of small round plaques, expressed by contact vulnerability and hyperemia.
Erosive-fibrous esophagitis is accompanied by the formation of a plaque on the mucous membrane in the form of gray fimbriated bands located at the apex of the longitudinal folds. There are erosions of various shapes. The mucous membrane of the esophagus is hyperemic, edematic and very vulnerable.
Another diagnostic method of candidiasis esophagitis is an X-ray study using a contrast medium.
A microbiological study of mucus taken from the esophagus is carried out by sowing it on nutrient media. After determining the causative agent of the disease, its sensitivity to antifungal agents is revealed. Cultural examination of biological material should be performed with recurrent candidiasis and fungal resistance to antifungal therapy.
Detect psevdotsiteliy allow morphological mycological methods with different types of staining smears: according to Romanovsky-Giemsa or with the coloring of biopsies by the SHIC-reaction.
Medicamentous treatment of esophageal candidiasis consists in the use of antifungal agents and stimulants of the immune system.
The choice of an antimycotic agent is determined by the results of laboratory tests and the detected sensitivity of the detected microorganism to various drugs.
There is a large amount of antifungal agents. To treat the esophagus the most effective are the means of systemic action, in other words, tablets - " ketoconazole ", " Fluconazole " and " Itraconazole ".
Popular is Fluconazole, it is taken at 100-200 mg / day orally for a month.
How else can I treat candida of the esophagus? A good effect is provided by endoscopic administration of high-intensity laser radiation and granulocyte concentrate to patients. This procedure helps improve immune functions.
Etiotropic therapy is almost always accompanied by the appointment of drugs that normalize the work of the gastrointestinal system and colonize epithelial tissues with bifidobacteria and acidophilic lactoflora. Patients are also shown pharmacological agents for enhancing immunological defense of the body.
Diet in esophageal candidiasis should provide the body with a sufficient number of proteins, vitamins and trace elements. Products containing many simple carbohydrates (sweet and flour) should be excluded from the patients' diet for a while.
Also, the nutrient medium for the fungal flora are dairy products and citrus fruits. They must also be deleted. Persons with severe forms of candidiasis, accompanied by swallowing disorders, are shown parenteral or probe nutrition with high-protein mixtures, together with adequate hydration.
Treatment of esophageal candidiasis is always complex, carried out under the supervision of the attending physician. Its effectiveness is determined by means of instrumental survey methods.