The source of infection in the human body is in the intestines and mouth. Infection of the esophagus occurs ascending and descending paths, respectively. Fungi multiply and show their pathogenic properties with a decrease in body resistance, immunodeficiency, or other favorable conditions.
The population of fungi of the genus Candida in the esophagus increases, which leads to the development of candidiasis.
From the external environment, the pathogen enters the body:
- upon contact with a patient or carrier,
- by eating contaminated food,
- when using contaminated household items and personal care products.
Factors provoking the development of esophageal candidiasis:
- esophageal injury or damage with sharp objects
- long-term corticosteroid treatment
- long-term antibiotic therapy
- long antacid therapy,
- intoxication of various genesis,
- smoking and alcoholism
- impaired motility of the digestive tract,
- lack of protein in the body after a long diet,
- parenteral nutrition
- organ transplantation
- hypofunction of the adrenal glands or parathyroid glands,
- immune pathologies - AIDS,
- effects of chemotherapy,
- severe chronic infections - tuberculosis.
Candida penetrates the tissues of the esophagus of a weakened organism, multiply actively and form pseudomycelia. Histological examination of biopsy specimens confirms the diagnosis of candidal esophagitis after the detection of mycelium filaments. Individual Candida colonies are found on the mucous membrane of the esophagus in normal conditions or indicate the carriage of the fungus. Such conditions do not require treatment.
Candida esophagus - one of the most difficult to diagnose 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 discharge of films
- loose stools with mucus.
The intensity of pain when swallowing varies from insignificant to pronounced, interfering with the normal intake of food and water. Such complications lead to dehydration.
At the initial stage of the disease, 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 are able to completely block the lumen of the esophagus.
Complications of esophageal candidiasis (what will happen if you do not treat and completely start the disease):
- tissue necrosis
- esophageal stricture.
- bleeding from blood vessels.
Esophagoscopy - the main diagnostic method of esophageal candidiasis. Esophagoscopy is performed for all patients complaining of difficulties and pain when swallowing food. Endoscopic examination allows to examine the mucous membrane of the esophagus with the help of special optical equipment.
Endoscopic signs of esophageal candidiasis:
- the vulnerability of the surface of the mucous membrane upon contact,
- puffiness and hyperemia,
- fibrous deposits on the mucous.
Catarral endophagitis is characterized by moderate edema of the mucous membrane, diffuse hyperemia, bleeding upon contact, the formation of whitish plaque on the surface.
Fibrinous esophalitis is manifested by loose raids in the form of small round plaques, pronounced contact susceptibility and hyperemia.
Erosive-fibrious esophagitis is accompanied by the formation of plaque on the mucous membrane in the form of gray fringed ribbons, which are located at the top of the longitudinal folds. Appear erosion of various forms. The mucous membrane of the esophagus is hyperemic, swollen and very vulnerable.
Another diagnostic method for candidal esophagitis is radiographic examination using a contrast agent.
Conduct a microbiological study of mucus taken from the esophagus, by sowing it on nutrient media. After determining the causative agent of the disease reveal its sensitivity to antifungal drugs. A cultural study of biological material should be carried out with recurrent candidiasis and fungus resistance to antifungal therapy.
Morphological mycological methods with various types of smear staining can detect pseudo-mycelium: according to Romanovsky – Giemsa or with a CHIC-colored biopsy specimen.
Drug treatment of esophageal candidiasis is the use of antifungal agents and immune system stimulants.
The choice of anti-mycotic agent is determined by the results of laboratory tests and the identified sensitivity of the detected microorganism to various drugs.
There are a large number of antifungal agents. For the treatment of the esophagus, the most effective are the means of systemic action, in other words, the pills - " Ketoconazole ", " Fluconazole " and " Itraconazole ".
Fluconazole is popular, it is taken 100-200 mg / day orally within a month.
How else to treat esophageal candidiasis? Endoscopic administration of high-intensity laser radiation and granulocyte concentrate to patients is of good effect. This procedure helps to improve the immune function.
Etiotropic therapy is almost always accompanied by the appointment of drugs that normalize the work of the gastrointestinal system and populate epithelial tissue with bifidobacteria and acidophilic lactoflora. Patients are also shown pharmacological agents to improve the immunological protection of the body.
Diet for candidiasis of the esophagus should provide the body with sufficient amounts of proteins, vitamins and trace elements. Products containing a lot of simple carbohydrates (sweet and flour) should be excluded from the diet of patients for some time.
Milk products and citrus fruits are also a nutrient medium for fungal flora. They must also be deleted. Persons with severe forms of candidiasis, accompanied by impaired swallowing, are shown parenteral or probe feeding of high-protein mixtures, together with adequate hydration.
Treatment of esophageal candidiasis is always complex, conducted under the supervision of the attending physician. Its effectiveness is determined using instrumental methods of examination.