Treatment of candida in the stomach. Stomach candidiasis: symptoms and treatment of a fungal disease. Can thrush be caused by the stomach?

Gastric candidiasis is a fungal disease that occurs as a result of infection with fungi of the genus Candida. It develops mainly in patients with reduced immunity, systemic diseases, and disorders of the gastrointestinal tract. Another name for the disease is thrush.

Disease in severe forms poses a threat to life and in some cases is treated inpatiently. At the same time, there are also mild forms of candidiasis, which are treated on an outpatient basis (at home) with the help of antifungal medications.

Causes of the disease

There are several causes of gastrointestinal thrush. The causative agent of the disease is fungi of the genus Candida, which enter the esophagus along with food. But fungi themselves do not cause infection of the body. The lesion develops in cases where the body of a person susceptible to the disease is weakened:

1. The patient suffers from immune diseases;
2. The intestinal microflora is disrupted, which is why pathogenic fungi begin to actively develop;
3. The person recently underwent antibiotic treatment, which also led to a deterioration of the microflora;
4. After heavy blood loss or viral disease the body's immunity is reduced.

Immune diseases

Candidiasis in the stomach can be in a dormant form: a small part of pathogenic fungi is often always found in the human intestines. Fungi begin to actively develop if the body’s immunity fails.

There are often cases when the disease develops after eating unwashed foods (vegetables, fruits, herbs). Fungal colonies can easily survive on unprocessed food. But even if it enters the esophagus, infection with fungi and the development of candidiasis occurs only if the protective mechanisms of the human digestive tract are disrupted.

Symptoms of candidiasis

Symptoms of thrush are not specific. The signs of the disease are similar to those of other gastrointestinal disorders (poisoning, alcohol intoxication, intestinal infection, kidney dysfunction). Specific symptoms appear only in the last stages of the disease, when fungi penetrate the walls of the stomach and corrode areas of the vascular system. Then internal bleeding, loss of consciousness, dizziness, and severe weakness suddenly begin.

Thrush in the stomach - symptoms:

• Vomit contains curdled discharge or streaks of blood;
• Anemia caused by a lack of iron in the blood;
• Stools with white film or blood;
• Apathy;
• Formation of ulcers;
• Unreasonable vomiting.

Symptoms do not appear immediately. It becomes very pronounced only in the later stages of the disease. In its early form, candidiasis can manifest itself in the form of cheesy discharge during bowel movements. A white film often forms in oral cavity, which is poorly separated from the mucous membrane.

Due to the fact that the symptoms are difficult to distinguish from signs of simple poisoning, infected people often delay seeing a doctor and do not receive proper treatment. If you ignore the disease, sooner or later internal bleeding may develop, which is life-threatening. Therefore, if there are persistent signs of indigestion or a white film is detected, you should immediately consult a doctor.

The disease goes through several stages development. First, the pathogen develops in the intestines, where conditions are most favorable for the spread of the colony. Then it moves to neighboring organs of the esophagus. There are other cases when infection occurs from the oral cavity: the fungus enters from the mucous membrane of the inside of the cheeks into the esophagus, then into the stomach.

General stages of development:

1. Initial. Symptoms of the disease are not yet noticeable. The fungus develops by inflaming the walls of the intestinal or oral mucosa.
2. The first manifestations of the disease. In the oral area, if it is infected, you can find redness, manifestations candidal stomatitis, white films, dry areas of the mucous membrane. The balance of microflora in the intestines is disrupted, which disrupts peristalsis. Diarrhea or constipation may occur.
3. Active development of the colony. The fungus begins to affect not only the surface of the mucous membrane, but also vulnerable areas of soft tissue (ulcers, polyps). By this time, even if the first focus of the disease was in the mouth, the disease has already reached the stomach. Due to the introduction of microorganisms into soft fabrics mild pain begins. Small streaks of blood can be found in stool and vomit. Patients don't always notice them.
4. On at this stage A bacterial infection may be added to a fungal infection. Then intoxication of the body is added to the symptoms. Due to the fact that the colony covers the stomach and intestines with a dense wall, the absorption of microelements is impaired. Vitamin deficiency develops, weakness and dizziness appear.
5. Stomach abscess or internal bleeding. Fungus eats away blood vessels. If a small vessel is affected, this leads to the development of iron deficiency. If a large vessel is damaged, internal bleeding begins, posing a threat to human life.

If the fungus begins to actively infect the blood vessels of the mucous membranes, this will lead to fatal outcome. The patient may fall asleep and not wake up due to sudden internal bleeding.

Invasive, non-invasive, general and focal forms of candidiasis

The severity of the disease depends on what form of candidiasis occurs within the gastrointestinal tract. Medical professionals divide the disease into four types:

1. Invasive candidiasis is a form of thrush in which the fungus begins to integrate into the structure of the mucous membrane. It is this process that threatens the appearance of bleeding. An invasive disease easily spreads to other organs.
2. The non-invasive form of candidiasis is less dangerous. It is quickly treated and does not require hospitalization. Gastric tract covered with a film, but fungi do not penetrate soft tissues and cause less damage.
3. Focal form – in other words, local. The fungus attaches only to certain parts of the gastrointestinal tract. Most often these are the affected areas of the mucous membrane, where there are the beginnings of an ulcer. With the focal type, the disease does not spread.
4. The general type of candidiasis is the most dangerous (especially if combined with invasive). The fungal colony does not affect separate part organ, but its entire surface. When the system reaches a sufficient level of development, it spreads to neighboring organs. This threatens to damage not only the gastrointestinal tract, but also the lungs, which is very difficult for a person to tolerate. If candidiasis is accompanied by bacterial infection, there is a risk of developing sepsis as a result of penetration pathogenic organisms into the circulatory system.

Diagnostic methods

Gastric candidiasis exhibits symptoms that are insufficient to make an accurate diagnosis. To differentiate the disease from other gastrointestinal diseases, you need to use one of the following diagnostic techniques:

• Culture of vomit or stool. As a result of sowing, fungal colonies develop, which makes it possible to detect the content of the microflora of the gastrointestinal tract. The detection period for the fungus is 5-7 days, which is too long if the patient is in critical condition.
• Polymerase chain reaction. It gives results earlier than sowing, so in critical cases it is considered a priority technique.
• Checking your blood for antibodies to yeast. Under normal conditions, the body does not produce antibodies aimed at fighting the fungus. If they are found in the blood, this indicates the presence of a fungal infection.

Before giving the patient a referral for tests, the doctor collects an oral and written medical history and examines the oral cavity for the presence of cheesy discharge.

The method of therapy must be determined by the doctor. The duration of treatment depends on the degree of development of the fungal colony and can take from 1 month to six months.

1. Non-invasive light form degrees. Treatment is carried out on an outpatient basis, using antifungal drugs that are not absorbed into the blood (local medications). Since the fungus has not affected other organs, this will be enough;
2. Invasive form. The patient should take systemic medications, the components of which are absorbed by the intestines;
3. Severe invasive form. The infected person is hospitalized. Medical personnel prevent internal bleeding and restore the mucous membranes of the gastrointestinal tract using systemic medications. In cases of peritonitis and ulcers, surgery may be required. A special diet is prescribed.

After completing therapy, it is recommended to consult a doctor again and do a preventive test (culture) to make sure that the fungus has been removed from the body.

Rehabilitation after treatment

Therapy for candidiasis includes the use of drugs that can be harmful to the intestinal microflora. After treatment, the patient often suffers from the following problems:

• Bloating;
• Flatulence;
• Stomach ache.

It is possible to rehabilitate a person to the state that preceded the disease with the help of multivitamin complexes, a short-term diet and taking lactobacilli.

Lactobacilli are recommended to be consumed as part of dietary dairy products. You can find drinkable and standard yogurts with probiotics. If dysbiosis is expressed by constant abdominal pain and digestive disorders, you should consult a nutritionist or therapist. The specialist will write a prescription for a restorative drug.

Flatulence and bloating are compensated with the help of a preventive diet. Excluded from the diet fatty foods, legumes, sour vegetables and greens (cabbage, sorrel). It is better to limit meat to white (chicken). Yeast bread is replaced with yeast-free bread. The duration of the diet depends on how quickly it helps to cope with ailments.

Prevention of candidiasis

Treatment of gastric candidiasis is a long process associated with monetary costs.

It is much better to provide the body with timely protection from fungi in order to reduce treatment costs and prevent complications. Prevention of candidiasis consists of a set of basic hygiene measures and various methods increasing immunity.

To prevent pathogens from entering the gastrointestinal tract, you need to:

However, even maintaining hygiene may not give the desired result. A person is susceptible to fungal infection as long as his body is weakened. To improve the body’s defense mechanisms and restore intestinal microflora, you should:

• For preventive purposes, take medications with lactobacilli (Linex). In hypermarkets you can find dairy products containing these beneficial microorganisms.
• Take multivitamins. A complete intake of vitamins and minerals into the body provides lasting protection against infections, viruses and fungi.
• Consume foods with ascorbic acid (lemons, citrus fruits, rose hips). The substance improves immunity. If the patient is already taking a multivitamin complex, additional intake of ascorbic acid is not necessary.
• Maintain proper digestion by consuming proper food, and protect the body from contact with the pathogenic environment.

Conclusion

Stomach thrush can be easily treated at an early stage using antifungal medications. In order for the therapy to be quick and painless, you need to strictly follow the doctor’s instructions and not neglect medical care.

The infectious disease gastric candidiasis or thrush occurs as a result of the entry and proliferation of yeast fungi of the genus Candida. They settle in colonies on the mucous membrane with the formation of a dense white coating, causing a violation of its integrity and the function of the digestive glands.

It is important to know the causes of the disease and the symptoms that candida causes in the stomach in order to consult a doctor in time, undergo treatment and avoid the development of complications.

Yeasts are very common in environment, and they always fall into digestive tract with food and drink. However, some people do not develop the disease, while in others they lead to candidiasis. The reason for this is the excessive, uncontrolled proliferation of fungi and their acquisition of pathogenic properties against the background of a decrease in the body’s immune defense.

The following conditions contribute to the development of candidiasis in the gastrointestinal tract:

Most often, fungal infection begins in the oral cavity, then the process spreads to the esophagus, stomach and the entire digestive tract. Therefore, the presence of thrush in the mouth always requires a visit to the doctor.

Clinical manifestations and course of the disease

Candidiasis developing in the stomach does not have specific symptoms and is manifested by signs of a general and local nature. General symptoms are the result of intoxication of the body: lethargy, weakness, feeling of malaise, decreased appetite, increased body temperature, headache.

Local symptoms are practically no different from gastritis and are expressed by abdominal pain, heartburn, belching of sour stomach contents, nausea, and vomiting. When the intestines are damaged, bloating and frequent stools appear. The only sign that allows one to suspect candidiasis is the presence of white flakes and lumps in the vomit and stool.

Diagnosis of gastric candidiasis

When examining the patient, you should be alert to spots and ulcers on the lips, cracks in the corners of the mouth (cheilitis), whitish plaque on the mucous membrane of the gums, tongue, and pharynx. In such cases, material is taken for microscopic examination.

The only reliable research method is fibroesophagogastroscopy - examination of the esophagus and stomach with a video probe. The endoscopic picture is typical: areas of white plaque are clearly visualized, tightly fixed to the mucous membrane, its swelling and redness are pronounced. This is clearly visible in the photo taken during gastroscopy.

Special forceps inserted through an endoscope are used to remove a small amount of material from several lesions for microscopic analysis.

Modern laboratory blood tests play an important role in diagnosis:

• immunological;
• molecular genetic.

Immunological tests

Two types of tests are used: enzyme-linked immunosorbent assay (ELISA) and indirect agglutination reaction (IAR). ELISA allows you to detect the presence of specific Candida antigens and the antibodies produced by the body to them, that is, “traces” of Candida.

RNGA is also based on identifying a fungal antigen that is fixed on the surface of red blood cells. When they are exposed to a specific antifungal serum, an antigen-antibody reaction occurs and red blood cells stick together - agglutination.

Molecular genetic research

The most modern method for diagnosing any infection, including fungal infections, is PCR (polymerase chain reaction) analysis. It is based on the determination, using the polymerase enzyme, of DNA sections specific to each type of microorganism. It is 100% reliable because it directly reveals the presence of fungus in the body.

Treatment of gastrointestinal candidiasis

For gastric candidiasis, complex treatment is prescribed, which includes:

Drug treatment of gastric candidiasis

Drug therapy is prescribed in a comprehensive manner, aimed at destroying the fungal infection, increasing the body's protective properties and eliminating the symptoms of the disease.

Antifungal drugs

Most effective means are antibiotics - Nystatin, Natamycin, Amphotericin, modern antifungal drugs are based on fluconazole ( Diflucan, Mikosist), based on ketoconazole ( Livarol, Mycozoral), clotrimazole.

The choice of such drugs is very large; they must be prescribed by a doctor, taking into account contraindications due to age, pregnancy and lactation.

Immunostimulants

They use so-called “smart” drugs that promote the body’s production of antibodies and interferon. Cycloferon and polyoxidonium have proven to be the most effective for candidiasis. To increase the protective properties, vitamin and mineral complexes are also prescribed.

Means of symptomatic action

For stomach pain and heartburn, it is prescribed Omeprazole, Ranitidine, Drotaverine, with nausea and vomiting - Cerucal. Severe diarrhea leads to loss of fluid and electrolytes, so Imodium is prescribed. good favor will bring drugs from the group of probiotics, restoring the normal protective intestinal microflora - Linux, Maxilak, Normoflorin,Bifiform and analogues.

Folk remedies

Facilities traditional medicine are not intended for independent treatment, but only as a good addition to the main treatment course. There are many recipes against thrush, here are some examples of the most effective:

• kombucha with garlic – 1 clove of grated garlic mixed with 1 glass kombucha, take 30 minutes before meals three times a day;
• infusion from a collection that includes equal parts of dry crushed herbs of wormwood, sage, aspen buds, oak bark, 1 tablespoon is brewed with a glass of boiling water, left in a water bath for 15 minutes, take 50 ml 30-=40 minutes before meals 3 times in a day;
• onion and citrus balm - grind 4 onions, 2 oranges and 2 lemons in a blender, add 100 ml of honey, stir well, take 1 tablespoon 30 minutes before each meal.

Dietary nutrition for pathology

Following a special diet - required condition successful treatment of gastric candidiasis. Its goal is to create conditions that are detrimental to Candida fungi and to exclude foods that contribute to its development.

Recommended to be included in the diet dairy products, especially biokefirs, bioyogurts, cereal porridges (except rice), fresh vegetables, fruits and berries (except bananas, figs, dates, grapes and dried fruits), boiled lean meat and seafood, eggs, seasonings - fresh onions, garlic, parsley, dill, celery.

Until recovery from the disease, confectionery products, baked goods, fatty, fried foods, canned food, smoked meats, potatoes, honey, cheeses, whole milk, cream, sour cream, alcohol are excluded from the menu, and the consumption of sugar and salt is limited as much as possible.

In any case, the diet should be agreed with the doctor, depending on the clinical form of the disease and the presence of complications.

Useful video

Why candida overgrows can be found in this video.

Possible complications of gastric candidiasis

Long-term, untreated gastric candidiasis can lead to the development of complications:

• chronic gastritis;
• peptic ulcer;
• stomach bleeding;
• perforation of the stomach wall and the development of peritonitis.

It has also been established that chronic candidiasis creates conditions for the development of stomach cancer.

Preventive actions

You can prevent the development of fungus in the oral cavity, esophagus, stomach and intestines by following simple preventive measures, for this you need to adhere to the following rules:

• carefully observe the rules of personal hygiene and take care of the oral cavity;
• adhere to a balanced diet, do not abuse sweets, fast food, alcohol;
• lead an active lifestyle, do exercises, sports, and hardening;
• do not take any medications without a doctor’s prescription and supervision;
• be sure to undergo regular medical examinations, especially children and the elderly, pregnant women.

We must not forget that seemingly harmless, banal thrush in the mouth can turn into a real threat to health; do not resort to self-medication, but first see a doctor.

Infection of the body by yeast-like fungi (the genus Candida is especially common) most often manifests itself as candidiasis of the skin and mucous membranes.
However, with an incompletely cured or advanced variant of this disease, fungal spores can infect internal organs and systems.
The gastrointestinal tract is primarily targeted, since fungal cells naturally spread from the oral cavity and penetrate the mucous membranes of the digestive system (esophagus, stomach, intestines).

Epidemiology

Fungal spores can be transmitted either directly from a sick person to a healthy person through contact or by airborne droplets, and through contaminated objects. Currently, there is more and more talk about autoinfection (infection with microorganisms that are normally present in a healthy body), since fungi of the genus Candida are found among the normal microflora of human skin.

Patients suffering from immunodeficiencies of various natures are susceptible to infection with fungal spores.

Protracted infectious processes can affect a person’s immune status, malignant neoplasms, diabetes mellitus, trauma, age (children and older people are more likely to get sick), long-term treatment antibiotics, unfavorable socio-economic status, bad habits (smoking, alcohol abuse).

Symptoms and diagnosis

Candidiasis of the digestive organs is classified according to the location of the lesion. Among other things, the most common ones are:

• Candidiasis of the esophagus (candidal esophagitis);
• Candidiasis of the stomach (candidiasis gastritis);
• Intestinal candidiasis (candidal enterocolitis).

Candidiasis of the esophagus

With candidal esophagitis, patients complain of difficulty swallowing, chest pain after eating, and sometimes vomiting. The clinical picture of esophageal candidiasis is usually masked as a picture of stenosis or tumor, and therefore requires additional research methods.

When performing esophagoscopy, white films and a cheesy coating with a yellowish (often grayish) tint are noted on the mucous membrane of the esophagus - obvious signs candidiasis. When the films separate, erosions remain on the mucous membrane, and in severe forms, when the deeper layers of the esophageal wall are also involved in the process, bleeding is noted.

During instrumental examination of the esophagus, material (film on the mucous membrane) is collected for microscopic examination.

Gastric candidiasis

Fungal infection of the stomach takes the form of chronic gastritis: there is a decrease in appetite, pain in the epigastric region, nausea and vomiting. During laboratory testing, fungal particles can be detected in vomit, and the presence of cheesy films can be visually noted.

Studies have shown a decrease in stomach acidity, which only contributes to further development fungus in the walls of the stomach. FEGDS shows a picture similar to candidal esophagitis: swollen and inflamed mucosa with islands of white-yellow films.

Laboratory analysis of the material obtained during FEGDS and microscopic examination of vomit (if available) is also necessary for making a diagnosis.

On our website you can find more complete information about this disease. She is located .

Intestinal candidiasis

In the case of candidal enterocolitis, dysbacteriosis may become an additional factor of infection. If, in the case of fungal infection of the esophagus and stomach, doctors often discover that the patient has undiagnosed or is in remission oral candidiasis, then in in this case the primary focus may be the intestinal wall.

Among other things, the most common cause autoinfection is a decrease in immunity (as a consequence of dysbacteriosis). The connection is that intestinal microflora is one of the factors protecting the human body. And when under the influence of negative factors (uncontrolled medication, stress, poor diet, inflammatory processes of different nature) microorganisms take a pathogenic form, this affects the patient’s immune status.

Complaints with candidal enterocolitis are different and depend on the severity of the disease: from discomfort in the abdomen to pronounced pain and frequent diarrhea. But in any case, traces of the fungus can be found in the discharge.

Upon instrumental examination, the picture does not differ from other forms of fungal infection of the mucous membrane.

Treatment

Oral antimycotics are used to treat candidiasis of the digestive system. It is very important to diagnose and begin treatment in time, as this will help to avoid the spread of fungal spores into the deeper layers of the walls of the digestive organs and reduce the risk of developing generalized candidiasis.

In some cases, doctors prescribe a couple of drugs for more effective therapy. An important property of drugs is poor absorption in the gastrointestinal tract - thus, medicinal substances act in the organ cavity and do not have negative impact on the body as a whole.

The treatment regimen uses and similar drugs in the forms of capsules, suspensions and rinsing solutions. The dose and duration of treatment are prescribed by the attending physician.

For candidal enterocolitis, along with antimycotics, eubiotics are used to help restore the balance of the microflora. These drugs are prescribed after antifungal therapy has completed (approximately two to three weeks). Taking eubiotics themselves is quite long and depends on the severity of dysbiosis - from four weeks or more. Applicable:

• Baktisubtil;
• Hilak-forte;
• Linux.

If gastric candidiasis is diagnosed, you can prescribe enzymes and drugs that improve the functions of the digestive organs, thus normalizing acidity and reducing the risk of infection in the future.

The diet for fungal diseases of the digestive system is standard: split meals with a predominance of proteins, food enriched with vitamins A, B, C and a moderate amount of carbohydrates in the diet.

Prevention measures

Since candidiasis of the gastrointestinal tract is most often a secondary disease, you should carefully monitor your health: do not ignore the manifestations of candidiasis on the skin and mucous membranes, carefully follow the doctor’s instructions for diagnosed candidiasis, monitor your diet, take medications only under the supervision of specialists.

Candidiasis is the most common fungal infection today, caused by yeast-like fungi of the genus Candida. The increase in the incidence of this mycosis (from the Greek μύκης - fungus) in recent decades is associated with the widespread use of antibiotics and an increase in the number of patients with immunodeficiencies. Pathogens belong to the group of opportunistic microorganisms.

The frequency of candidiasis is 25% in the oral cavity and 70 - 80% in the intestines. The human immune system inhibits the development of the disease. Under normal conditions, the amount of saprophytic flora is negligible. When the immune system malfunctions, there is an excessive growth of fungi. They affect mucous membranes, skin and internal organs. The most frequently reported cases are intestines. Among the digestive organs, the esophagus, stomach, rectum, bile ducts and pancreas are also affected.

Microorganisms are widespread in nature. They are found in drinking water, soil, food products. They live on the skin and mucous membranes of animals and humans. Of the 200 biological species of yeast-like fungi of the genus Candida, 10 species pose a danger to humans, of which about 87% are Candida albicans.

Rice. 1. Mushrooms of the genus Candida: round shape (photo on the left), micellar shape (photo on the right).

Virulence factors of pathogens

The development of candidiasis of the intestines, esophagus and stomach is facilitated by the special properties of pathogens:

• Fungi of the genus Candida have the ability to attach to cells of the mucous membrane and then, transforming into a filamentous form (mycelium formation), penetrate the mucous membrane (invasion), causing tissue necrosis due to the secretion of enzymes such as aspartyl proteinase and phospholipase. Adhesion and pseudomycelium formation are the main virulence factors of Candida.
• Enzymes of protease and glycosidase pathogens intensively break down mucin (mucopolysaccharides of mucus), which protects the mucous membrane of the esophagus, stomach and intestines from aggressive external factors.
• Intraspecific variability contributes to the development of resistance in microorganisms to negative environmental factors, including antifungal drugs.

Factors of antifungal resistance of the body

The human body opposes its defenses to Candida virulence factors:

• Formation of mucopolysaccharides (mucin, mucus), production of lysozyme, complement, secretory IgA, transferrin, lactoferrin, acids and enzymes, ability to regenerate mucous membranes, maintenance of normal microbiota (intestinal microflora), peristaltic activity.
• Condition is decisive cellular immunity phagocytic series - natural killer cells, polymorphonuclear leukocytes and mononuclear phagocytes, antifungal humoral response (synthesis by B cells of specific immunoglobulins that inactivate enzymes and endotoxins of fungi), and the complex interaction of dendritic cells with T helper cells and T regulatory cells.
• Limiting the growth of Candida by symbiont bacteria (bifidobacteria, lactobacilli, enterococci,).
• The normal microflora of the gastrointestinal tract produces substances that prevent the penetration of pathogenic microorganisms into the mucous membrane.

Factors contributing to the development of candidiasis

• Physiological immunodeficiencies (pregnancy, childhood and old age, prolonged stressful situations).
• Primary immunodeficiencies (congenital).
• Oncological diseases and AIDS.
• Taking glucocorticoids, cytostatics, radiation therapy.
• Taking contraceptives containing large amounts of estrogens.
• Diseases endocrine system(decompensated diabetes mellitus, obesity, hypothyroidism, etc.).
• Dysbiosis caused by long-term antibiotic therapy.
• Chronic diseases that debilitate the patient.
• Injuries, surgeries, prolonged stress - everything that attacks the immune system.

Defects in the antifungal immune system are the main factor contributing to the development of candidiasis in humans.

Rice. 2. Candida mycelium on the surface of the mucous membrane forms a powerful framework - a biofilm. The process is accompanied by destruction of the mucous layer with the formation of erosions and ulcers.

Classification of candidiasis of the digestive organs

1. Oro-pharyngeal candidiasis (oral cavity and pharynx): seizures, cheilitis, gingivitis, stomatitis, pharyngitis, glossitis.
2. Candidiasis of the esophagus (without erosions and with erosions).
3. Stomach candidiasis:

• Erosive-fibrinous (diffuse).
• Focal (secondary gastric ulcers).

1. Intestinal candidiasis:

• Invasive diffuse.
• Non-invasive.
• Focal (secondary ulcers 12 duodenum).

1. Ano-rectal candidiasis:

• Candidal proctosigmoiditis.
• Invasive candidiasis of the rectum.
• Candidal dermatitis of the perianal area.

Rice. 3. The photo shows yeast-like fungi Candida albicans under a microscope. Threads of pseudomycelium, chlamydo- and blastospores are clearly visible.

Diagnosis of the disease

Diagnosis of candidiasis of the intestines, esophagus, stomach and other digestive organs is based on the clinical picture of the disease, identification of risk factors and data laboratory methods research.

History of the disease

A thorough study of the patient’s complaints and the history of his illness and life will reveal whether the patient belongs to risk groups. The “accidental” detection of a fungal infection serves as a reason to search for such background factors. Often candidiasis appears first in the development of diseases accompanied by immunodeficiency.

Microscopy of native preparations

Detection of pseudomycelium of budding pathogen cells in scrapings from the mucous membrane, urine sediment, feces or sputum, and impression smears from the bottom of ulcers during microscopy is the “standard” for diagnosing mycosis.

Rice. 4. Candida albicans under a microscope: round cells and filaments of pseudomycelium.

Rapid identification technique

The method of rapid identification of Candida albicans is widely used. Microorganisms of this species are capable of forming short mycelial threads and germ tubes within 2 - 4 hours when growing on nutrient media at a temperature of +37°C.

Cultural examination

A cultural study is carried out to identify the causes of the disease, determine the quantitative assessment of pathogens, their species and sensitivity to antifungal drugs. To conduct this study, swabs from the mucous membrane of the oral cavity and esophagus, the contents of the stomach and intestines, plaque, films, and bile obtained through duodenal intubation are used.

Interpretation of some research results:

• In persons with normal immunity, the detection of single Candida colonies is not a basis for making a diagnosis of Candidiasis.
• The number of colonies is more than 10 5 and is diagnostically significant.
• In individuals with a low level of immunity, a lower diagnostic level is significant.
• In some cases, with intestinal damage, the detection of candida in the stool may be the only sign of the disease.

Rice. 5. The photo on the left shows the growth of Candida albicans colonies on a nutrient medium. The photo on the right is a view of a fungal colony with filamentous cells at the top.

Histological examination

Histological and cytological examination of biopsy specimens makes it possible to identify tissue forms of pathogens.

Analysis of stool for colon microflora

In the case of non-invasive intestinal candidiasis and when biopsy material is not available, the diagnostic standard is a Candida growth of more than 10 4 CFU/g. An increase in this level indicates a decrease in immune defense, long-term use of antibiotics, or consumption of foods high in carbohydrates.

Rice. 6. Excessive growth of Candida albicans in intestinal contents.

Other laboratory research methods

Have practical significance linked immunosorbent assay fecal antigens and PCR.

Endoscopic research methods

An endoscopic examination of the esophagus, stomach and duodenum allows us to identify inflammation of the mucous membrane and the presence of whitish deposits, and take a piece of material for examination. Modern techniques Video and colonoscopies (examination of the large intestine) allow you to examine the organ in conditions that are comfortable for the patient - against the background of “medicinal” sleep.

X-ray examination

X-ray examination allows us to identify defects in the contours of the mucous membranes, the size of the feeding tubes and the depth of peristalsis.

Detection of pseudomycelium of yeast-like fungi is the “standard” for diagnosing the disease.

Rice. 7. Candida albicans under a microscope.

Intestinal candidiasis: symptoms, treatment, diet

Among all types of candidiasis, intestinal damage occupies a leading place. The disease is caused by a decrease in the body's defenses and the widespread use of antibacterial drugs. wide range actions. Infection is often called a “disease of the sick” or “disease of the cure.”

How the disease develops

There are invasive and non-invasive forms of the disease. In the invasive form, the fungi grow into the intestinal mucosa; in the non-invasive form, they develop in the intestinal lumen.

Invasive form

With invasive candidiasis, candida adheres to the epithelial cells of the intestine, forms filamentous outgrowths (pseudomycelium), grows into the epithelial layer and penetrates beyond the basement membrane. Next, the pathogens enter lymphatic system and are distributed throughout the body in the blood. This is how systemic candidiasis develops with damage to internal organs.

The disease develops in the digestive organs, the inner wall of which is lined with multilayered squamous (more often) and cylindrical (less often) epithelium. More often the disease occurs in the oral cavity and esophagus, less often in the stomach and intestines. Erosive and ulcerative defects of the intestinal wall have different shapes and sizes. Cracks, membrane deposits and polyp-like formations appear.

Rice. 8. During the active phase, candida forms pseudomycelium that grows through the intestinal mucosa.

Non-invasive form

In the non-invasive form of candidiasis, fungal cells do not form pseudomycelium and do not germinate the intestinal mucous layer. They multiply intensively in the lumen of the organ, disrupting cavity and parietal digestion. Microbial components and metabolites inhibit normal microflora, penetrating into the blood, they lead to the development of systemic immune-inflammatory reactions and allergic restructuring of the body.

The bulk of yeast-like fungi of the genus Candida are localized in the human intestine. Extraintestinal localization of mycosis (oral cavity, genitals and internal organs) is a manifestation of systemic candidiasis, the beginning of which in most cases is intestinal damage.

Signs and symptoms of intestinal candidiasis

Symptoms of intestinal candidiasis depend on the form of the disease, level and extent of damage.

1. Abdominal discomfort is the leading symptom of intestinal candidiasis. The patient experiences spastic pain, bloating (flatulence), and blood and mucus may be present in the stool.
2. The frequency and consistency of stool changes. Yeast-like fungi of the genus Candida are detected in large quantities in feces.
3. A constant symptom of intestinal candidiasis is flatulence - the release of digestive gases with sound. varying degrees volume and foul odor.
4. Intoxication during the disease is moderate.
5. Sensitization of the body is characterized by signs of allergies of varying localization and severity.

Signs and symptoms of intestinal candidiasis (diffuse invasive form)

The diffuse invasive form of intestinal candidiasis occurs as enterocolitis. Patients are concerned about spastic pain, bloating, blood and mucus may be present in the stool, and signs of candidiasis of the mucous membranes of the oral cavity and genital organs often appear. Fever is moderate. Changes in the intestines during endoscopy of a fibrinous-ulcerative nature. Sometimes the disease occurs as a nonspecific ulcerative colitis or duodenal ulcer. In some cases, perianal dermatitis develops. Treatment with antifungal drugs gives a positive result.

Signs and symptoms of intestinal candidiasis (non-invasive form)

The non-invasive form of intestinal candidiasis occurs with abdominal pain and bloating, foul-smelling gases are released with sound, and unformed stools. Treatment with antifungal drugs gives a positive result.

Rice. 9. The photo shows intestinal candidiasis. The arrows indicate the “curdled” type of application.

Complications of intestinal candidiasis

• With a long course of candidiasis, an allergic restructuring of the body occurs, which is characterized by the appearance of urticaria, itchy skin, allergic vasculitis or fungal eczema.
• In severe forms, invasive intestinal candidiasis is complicated by perforation of ulcers and bleeding.
• When pathogens enter the vascular bed, candidal sepsis occurs. Of the parenchymal organs, the gallbladder, liver, and pancreas are affected, which is often observed in patients with AIDS.
• The systemic nature of mycosis is indicated by simultaneous damage to the oral cavity and/or genital organs.

Mortality with invasive intestinal candidiasis reaches 25 - 55%. In patients after transplantation and with acute leukemia invasive forms of mycosis are the main causes of death.

Rice. 10. In some cases, intestinal candidiasis occurs as fibrinous ulcerative colitis.

Treatment of intestinal candidiasis

Treatment of intestinal candidiasis is aimed at the effective destruction of pathogens and all parts of the pathological process. It is necessary to identify and eliminate factors contributing to the development of mycosis. During the treatment process, patients must follow a strict diet and give up bad habits.

Treatment of intestinal candidiasis with antifungal drugs

When treating candidiasis, antifungal drugs are used that are not absorbed from the intestinal lumen, since without suppressing the growth of candida, the therapeutic effect is not observed, or is unstable and short-term. Flucanazole, Ketoconazole, Intraconazole and Amphotericin are completely absorbed in the upper gastrointestinal tract and do not reach the level of the ileum, where the main population of Candida fungi is concentrated.

The group of antifungal drugs that are not absorbed from the intestinal lumen includes Nystatin, Levorin And Natamycin (Pimafucin). Nystatin And Levorin have a large number of side effects: dyspepsia, toxic hepatitis, allergies, etc.

Pimafucin is a broad-spectrum antifungal drug from the group of polyene antibiotics. Under its influence, integrity and function are disrupted cell membranes, which leads to the death of pathogens. At the beginning of treatment, patients experience nausea and diarrhea, which go away on their own without stopping the drug. Pregnancy and breastfeeding are not a contraindication. No data on the effect on the fetus have been obtained.

The main criteria for the effectiveness of treatment are:

• Disappearance clinical manifestations diseases.
• Normalization of the number of candida colonies, subject to adequate analysis.

In some cases, repeated courses of treatment are resorted to to obtain the desired effect.

Rice. 11. Under the influence of antifungal drugs, the shell of mushrooms becomes porous, “leaky.” The contents of the cell flow onto the surface of the mycelium.

Pathogenetic treatment of candidiasis

Complex treatment of mycosis should be aimed at correcting the patient’s immune status, reducing the body’s sensitization and restoring the intestinal biocenosis, which will significantly increase the effectiveness of treatment.

1. In order to reduce sensitization of the body, patients are recommended to take new generation antiallergic drugs.
2. In order to replace the loss of vitamins and microelements (including iron), it is recommended to take Ferroglobolin B12, which contains B vitamins (B1, B2, B3, B6 and B12), folic and pantothenic acid, vitamin C, iron ammonium citrate, calcium glycerophosphate, zinc, copper, manganese, iodine, lysine, licorice root extract and honey.
3. Restoration of intestinal microbiocenosis.

Restoration of intestinal microbiocenosis should take place in two directions:

• Fighting opportunistic flora (taking antibiotics, Intestopan, Mexaform, eating foods with a bactericidal effect).
• To normalize the intestinal flora, it is recommended to take medications containing live lacto-, bifido- and other types of bacteria: Linexa, Acipol, Hilak-forte, Bifi-Forma, Bifibumbacterin, Baktisubtil, Lactobacterin, Acylact, Lacteol, Profora, Bitsilak.

Dietary supplement for food Bactistatin is an indispensable multicomponent drug in the treatment of candidiasis:

• Metabolites of Bacillus subtilis inhibit opportunistic and pathogenic intestinal microflora, promote complete digestion, increase the body's defenses by stimulating the synthesis of interferon.
• Zeolite is a natural sorbent. Selectively absorbs and removes allergens and toxins, thereby helping to reduce various types toxicosis. When exposed to it, intestinal motility is normalized, bloating and spastic phenomena are reduced.
• Soy flour hydrolyzate is a prebiotic component. It promotes growth and...

1. Drugs that suppress fermentation processes are used ( Karbolen— Activated carbon) and normalizing digestion ( Pepsidid, Gastric juice, Acidin-pepsin, Magnesium sulfate, enzyme preparations).
2. When the hemoglobin level in the blood is low, iron supplements are used: Ferroplex, Iron lactate, Iron glycerophosphate, Hemostimulin.
3. In order to combat hypoproteinemia to normalize nitrogen metabolism, patients are prescribed anabolic steroids: Inosine, Nandrolone, Orotic acid, Methyluracil and etc.
4. In case of proven functional and quantitative deficiency of the T- and B-cell immunity, immunomodulators are prescribed: Sodium nucleinate, Splenin, Taktivin, Arbidol, Levamisole, Splenin, Methyluracil and etc.
5. To correct humoral immunity, human immunoglobulin, gamma globulin, etc. are used.

Diet for intestinal candidiasis

1. Yeast-like fungi of the genus Candida prefer to live in tissues rich in internal sugar - glycogen. In order to reduce fermentation processes and combat gastrointestinal dyskinesia, it is recommended to limit the consumption of the daily intake of sugar and foods containing large amounts of carbohydrates. Sweets, confectionery, pastries, white bread, pasta, sweet drinks, beer and kvass, potatoes, beets and corn, grapes, bananas and other sweet fruits are not recommended for consumption.
2. Allowed for consumption: lean meats stewed, boiled or baked, boiled chicken eggs and omelet, vegetable oils, fermented milk products, from vegetables - cucumbers and tomatoes, from cereals - buckwheat and rice, from berries - currants, lingonberries and cranberries in the form of fruit drinks, from drinks - herbal decoctions, pomegranate or carrot juice, rosehip decoction, green tea, drink with lemon without sugar.

A highly effective antifungal drug, anti-inflammatory, restorative and immunomodulatory agents, correction of concomitant diseases are the basis for the treatment of candidiasis of the digestive tract.

Rice. 12. Yeast-like fungi Candida albicans under a microscope: rounded pathogen cells and fragments of pseudomycelium filaments are visible.

Esophageal candidiasis: symptoms and treatment

Esophageal candidiasis is rare (in 1.3% - 2.8% of patients), mainly in people with reduced immunity, in 4% of patients after transplantation, in 3 - 6.7% of patients with disseminated carcinomatosis, in every third patient with AIDS , often observed in patients with dysfunction of the adrenal glands and parathyroid glands, in 5 - 10% of patients with diabetes mellitus. The main risk factors for the development of esophageal candidiasis are burns, polyposis and diverticulosis.

Classification

Candidal esophagitis can occur without erosions and with erosions. Morphologically, there are 3 degrees of severity of mycosis:

• At the 1st degree of severity, individual gray-white plaques appear on the esophageal mucosa. Pseudomycelium of fungi grows into the epithelial layer.
• At the 2nd degree of severity, the plaques are filmy, in some places they merge, forming large areas. Mycelium threads grow into the mucous and submucosal layers.
• At the 3rd degree of severity, the pseudomembrane overlays are extensive. The mycelium threads grow into the muscle layer.

How does esophageal candidiasis develop?

Sticking to the cells of the mucous membrane of the esophagus and not receiving proper resistance from the immune system, candida begins to form pseudomycelium and grow through the mucous layer. Under the influence of pathogenic enzymes, mucosal cells are destroyed. The desquamated epithelium and fungal bodies form plaques on the surface that are gray-white in color. At first these are small whitish patches, which over time merge and form dense deposits - films. In some cases, there are so many filmy deposits that they completely block the lumen of the esophagus. In patients with immunodeficiency, ulcers appear, and perforation (perforation) of the wall and bleeding often occur. Phlegmonous inflammation of the esophagus and mediastinum causes death in patients. Microscopy reveals pseudomycelium and budding cells of pathogens.

Rice. 13. Formation of mycelium on the surface of the mucosa. In the photo on the right you can see pseudomycelium and round-shaped chlamydospores - organs of asexual reproduction. The process is accompanied by destruction of the mucous layer, followed by the formation of erosions and ulcers.

Symptoms of esophageal candidiasis

Based on the endoscopic picture, 4 types of the course of the disease are distinguished - from mild to severe, complicated. Candidiasis of the esophagus with a latent course can be asymptomatic.

The main symptoms of esophageal candidiasis are dysphagia (unpleasant sensations when swallowing), pain (odynophagia), and in some cases drooling (hypersalvation). Pain when swallowing of varying intensity, sometimes the inability to swallow food. When vomiting, filmy formations are released. Dysphagia occurs in 70% of cases, damage to the oral cavity - 45%, nausea and vomiting - 15%, weight loss - 8%, diarrhea - 2%, every third patient has no symptoms of esophageal candidiasis. Heartburn and loose stool rarely occur.

Complications of esophageal candidiasis:

• The inability to swallow liquid food leads to dehydration.
• Perforation of the wall (perforation).
• Bleeding with subsequent development of anemia.
• Development of stricture (narrowing) of the esophagus.
• Dissemination of fungal infection with damage to internal organs.
• Candidal sepsis.
• Phlegmonous inflammation of the esophagus and mediastinum causes death in patients.

Rice. 14. Hypersalvation (photo on the left), edema, hyperemia of the mucous membrane and “curdled” deposits are the main symptoms of esophageal candidiasis.

Diagnosis of esophageal candidiasis

Testing for esophageal candidiasis should be carried out on all patients with risk factors if they develop discomfort and pain when swallowing. The diagnosis is confirmed by the presence of candidal stomatitis in patients, but in its absence, damage to the esophagus is also not excluded.

Microscopy of native smears

Detection of pseudomycelium is the “standard” for diagnosing mucosal candidiasis. Fungal cells are detected both during the disease and during candidiasis.

Detection of pathogens is carried out by cytological (examination of native smears) and histological (examination of biopsy material) methods. Analysis of scrapings is the most reliable.

Culture method

Sowing biomaterial allows us to identify the cause of the disease and give quantification pathogens, determine the species of fungi and sensitivity to antifungal drugs, monitor the effectiveness of treatment. The disadvantages of the cultural method are the inability to differentiate candidiasis from candidiasis.

Serological and skin tests

Serological tests (ELISA, determination of specific IgE, etc.) and skin tests are rarely used in practice due to the lack of the required accuracy.

Quick diagnosis of esophageal candidiasis

Rapid diagnosis of esophageal diseases is carried out using a cytological brush and a balloon catheter. Instruments for collecting material are inserted through the nose or mouth. The obtained material is examined cytologically and culturally. The sensitivity of the method is much higher than histological examination of biopsy samples obtained during endoscopy, since fungi can be washed out from the surface of the mucous layer when processing the obtained material.

Rice. 15. Candidiasis of the esophagus. Microscopy of the contents of an esophageal ulcer. Threads of pseudomycelium and budding candida cells are clearly visible.

Endoscopic examination of the esophagus

This type of examination of the esophagus allows you to visually assess the picture of inflammation and collect material for research. The disadvantages are that biopsy forceps obtain a miniature piece of tissue, which significantly reduces the likelihood of detecting the information necessary to make a diagnosis, so a single biopsy is often not enough to confirm the diagnosis.

The main endoscopic signs of esophageal candidiasis are mucosal hyperemia, increased vulnerability to contact, fibrinous deposits of various locations, sizes and configurations.

1. With catarrhal candidal esophagitis, diffuse hyperemia of varying degrees of severity is noted, and moderate swelling of the mucous membrane. Increased bleeding is observed upon contact.
2. With fibrinous candidal esophagitis, against the background of swollen and hyperemic mucous membrane, gray-white or yellowish loose, round-shaped plaques 1 - 5 mm in diameter are noted. Increased bleeding is observed upon contact.
3. With fibrinous-erosive candidal esophagitis, the plaques are dirty gray, “fringed”, ribbon-like, located on the crests of the longitudinal folds. The mucous membrane is swollen and hyperemic. Increased bleeding is observed upon contact.

Rice. 16. Endoscopic picture of esophageal candidiasis.

Histological examination

Only histological examination of biological material makes it possible to identify pseudomycelium that has penetrated deep into the wall of the esophagus.

X-ray method

The X-ray method of examining the esophagus is ineffective, but it can be used to identify complications of the disease - stricture, ulcers, perforation.

Treatment of esophageal candidiasis

Treatment of esophageal candidiasis is complex. First, the search, identification and correction of underlying diseases is carried out. Drug therapy involves the use of antifungal drugs, immunocorrectors, pathogenetic and symptomatic agents.

Antimiotics are prescribed mainly in tablet form. Intravenous administration is used in case of candidiasis resistance to traditional treatment regimens and inability to swallow. Local therapy is not carried out.

For candidiasis of the esophagus, the following are used:

• Triazoles (azole compounds) (Fluconazole, Itraconazole). Medicines containing Fluconazole, are the “gold standard” in the treatment of patients with candidiasis. They penetrate well into the bloodstream.
• Imidazole derivatives (Miconazole, Ketoconazole, Isoconazole, Omoconazole, Clotrimazole, Econazole, Bifonazole, Oxiconazole, Butoconazole, Sertaconazole (Imidazole + Benzothiophene).
• Group of polyene antibiotics (Nystatin, Levorin, Natamycin, Amphotericin and Pimafucin). Not absorbed from the intestinal lumen.
• Echinocandins (Caspofungin, Anidulafungin, Micafungin).

First line drugs include Fluconazole, Ketoconazole And Intraconazole.

Medicines containing Fluconazole, are the “gold standard” in the treatment of esophageal candidiasis. They penetrate well into the bloodstream and are superior in effectiveness Ketoconazole And Intraconazole.

Second-line drugs include: Ketoconazole, Intraconazole, Amphotericin, Capsofungin, Voriconazole, Procanazole.

With the development of resistance to antifungal drugs, the treatment regimen changes:

• When treated with azoles ( Fluconazole) it is necessary to increase the dose of the drug. If ineffective, switch to another drug of this group - Intraconazole, which is prescribed in a higher dosage.
• If taking a high dose is ineffective Fluconazole(400 mg daily) switch to intravenous administration Amphotericin B. Resistance to this drug is rare.

Treatment of esophageal candidiasis is carried out only as prescribed and under the supervision of a doctor.

Gastric candidiasis

Fungal infection of the stomach rarely develops in the absence of damage to the organ wall. Among all types of specific lesions of the gastrointestinal tract, gastric candidiasis accounts for 5.2%. At chronic gastritis and in biopsy samples of stomach and duodenal ulcers, yeast-like fungi are found in 17 - 30% of cases.

Gastric candidiasis can be erosive-fibrinous (diffuse) or focal (secondary gastric ulcers). Candidiasis often develops in patients with peptic ulcer and gastroesophageal reflux diseases. Pathogens multiply intensively against the background of a decrease or absence of hydrochloric acid in the gastric juice (achlorhydria), especially in areas of ulcers and damage (erosions) of the mucous membrane. As a result, ulcers and erosions do not heal for a long time, and the germination of fungi into the submucosal layer causes pain and bleeding.

An endoscopic examination of the stomach and duodenum makes it possible to identify inflammation of the mucous membrane, the presence of whitish deposits, and take a piece of material for examination. Reliable confirmation of the diagnosis is based on the detection of pseudomycelium candida in cytological and/or histological preparations.

In recent years, fungi of the genus Candida have been increasingly isolated in association with Helicobacter pylori. It has been established that antiulcer therapy increases the incidence of candidiasis, and in the presence of fungi, stomach diseases are more severe.

Treatment in such cases should be carried out with antibacterial along with antifungal drugs.

Diffuse gastric candidiasis

Diffuse damage to the stomach develops against the background of hypochlorhydria, after surgery and burns. Endoscopy reveals signs of fibrinous-ulcerative gastritis, and filaments of pseudomycelium are revealed in fingerprint smears. For treatment, Fluconazole 200 mg per day is used for 10 - 14 days or the drug Amphotericin B.

Focal gastric candidiasis

Focal (limited) damage to the stomach (ulcer candidiasis) develops against the background of gastric ulcer or duodenal ulcer. Ulcers are usually large sizes, prone to bleeding, tolerant to traditional treatment. Invading pseudomycelium is found in biopsy specimens and fingerprint smears. Fluconazole is the drug of choice, used at a dose of 200 mg per day for 10 to 14 days.

Rice. 17. Gastric ulcer (photo on the left) and duodenal ulcer (photo on the right, indicated by arrows).

Pancreatic candidiasis

It has been proven that Candida fungi affect the pancreas to the same extent as other organs. The disease causes the development of diabetes mellitus, which has been proven by obtaining positive dynamics when prescribing antifungal drugs.

Candidiasis of the biliary system

Fungi of the genus Candida can infect the gallbladder and bile ducts. This is facilitated by biliary dyskinesia, cholestasis, giardiasis, pancreatic diseases, hypotension of the gallbladder and other types of pathology. This creates conditions favorable for the development of pathogens. Stones in bile ducts become “reservoirs” for fungi. A number of authors call them “candida stones”.

Laboratory diagnosis is based on microbiological examination of bile portions obtained through duodenal multifractional intubation.

Antifungal drugs are prescribed during treatment Nystatin, Mycoheptin, Levorin, choleretic and antimicrobial drugs. Physiotherapeutic procedures complement the treatment. The diet should include foods rich in proteins, wholemeal bread, fermented milk products, lemonade and fruit juices. You should limit foods with a lot of carbohydrates. Meals are fractional, in small portions 5 - 6 times a day.

Rice. 18. Anorectal candidiasis.

Ano-rectal candidiasis

Damage to the anorectal area by fungi of the genus Candida occurs due to the introduction of pathogens into the intestinal wall of pseudomycelium. Mycosis develops against the background of decreased functioning of the immune system and is a consequence of intestinal candidiasis. Often in pathological process the skin of the perianal area is involved.

Candidiasis of the rectum

Candidiasis of the rectum often develops in patients with AIDS, homosexuals, and as a mixed infection with herpes lesions, proceeds as proctitis. Pain in the rectal area, false urges to the act of defecation, blood and mucus in the stool are the main symptoms of the disease. During sigmoidoscopy, against the background of edema and hyperemia of the mucous membrane, red papillae and granulations are visible, and increased bleeding is noted. In severe cases, ulcers appear, the process extends to the perineal area and external genitalia. Bipolar lesions are often observed - thrush in the mouth and rectum. Anorectal candidiasis lasts a long time and is difficult to treat.

The diagnosis is established based on the detection of pseudomycelium of fungi in fingerprint smears. In treatment it is used Fluconazole 200 mg per day for 14 - 20 days, from second-line drugs - Intraconazole And Ketoconazole. Additionally, local treatment is carried out using suppositories with Nystatin And Levorin, microenemas with water suspension Levorina, 0.02% methylene blue solution.

Perianal candidal dermatitis

Skin lesions in the perianal area occur with complaints of itching and burning. The act of defecation becomes painful, cracks and bleeding appear. On examination, hyperemia, numerous erosions and folliculitis are noted.

The diagnosis is made based on the detection of pseudomycelium candida in skin flakes. During treatment, antifungal drugs are used in the form of cream and ointment for external use with Clotrimazole. Second-line drugs include ointments and creams Nizoral or Exoderil. At severe itching Antimiotics with hormones are used.

Rice. 19. The photo shows perianal candidal dermatitis.

Articles in the section "Candidiasis (thrush)"Most popular

The disease gastric candidiasis, widespread throughout the world, is one of the forms of thrush familiar to most women.

Reproduction of the yeast-like fungus Candida in the gastrointestinal tract of an adult or child is a signal of trouble in the whole organism.

The fungus begins to become active only against the background of a decrease in a person’s immunity.

Therefore, if you suspect candidiasis, you should undergo full examination and a course of restoration of intestinal microflora.

Fungal infection of the gastrointestinal tract

In the gastrointestinal tract, the microorganism helps digestion processes and metabolism.

But only until the person’s immunity is in a normal state.

As soon as there is any malfunction in the body, the fungus multiplies and causes harm.

Infection of the digestive system with the yeast-like fungus Candida is possible in two ways:

Initially, the infection enters the body through airborne droplets, through dishes, dirty hands, and food. Children can become infected with the fungus in the prenatal period or during passage through the birth canal.

Regardless of the route of infection, the cause of the development of gastric candidiasis is a weakening of the human immune system. The pathogen begins to put pressure on beneficial bacteria with its quantity.

The reasons for the onset of activation of the Candida fungus are the following circumstances:

The development of candidiasis is facilitated by the presence of gastrointestinal diseases:

• gastritis;
• stomach ulcer;
• dysbacteriosis;
• low acidity of gastric juice;
• mucosal necrosis.

Additionally alcoholism, smoking, drug use, increased amounts of spicy food contribute to the disease. The age of the patient plays an important role, since after 50 years the functioning of the gastrointestinal tract worsens.

Symptoms

The presence of yeast-like fungus in the stomach is manifested as follows:

From the stomach the pathogen begins to spread into the esophagus, additional signs appear:

• pain when swallowing food;
• dry mouth mucous membranes;
• plaque in the mouth;
• smell from the mouth;
• burning in the esophagus;
• weight loss.

It affects the surface of the stomach and esophagus, narrows the space, impairing patency. Gradually, the person experiences pain even when swallowing water.

Diagnostics

To make a diagnosis, contact a gastroenterologist. Special examinations are carried out in the clinic:

The most informative diagnostic method is endoscopic examination of the esophagus and stomach. Examination with an endoscope allows you to assess the condition of the mucous membrane, take tissue for histological analysis, and materials for culture.

During this examination, the doctor may begin treatment by cauterizing the bleeding and removing the polyp.

IMPORTANT! Sowing gastric juice helps determine the type of fungus, as well as determine the body’s immunological reaction: determine whether antibodies are produced to it.

Treatment

The treatment complex includes taking systemic antifungal drugs, strict adherence to a diet, and strengthening the body with vitamin and mineral complexes.

The treatment regimen and set of medications are determined by the doctor, based on information about the stage of the disease and concomitant pathologies in the body.

Fungal diseases are markers of failures in immune system, therefore, when a yeast-like fungus is detected, restoration measures begin first.

At the second stage, the intestinal microflora is improved.

After preparatory therapy, pathogenic microflora is destroyed with antifungal drugs and concomitant inflammatory processes are treated.

IMPORTANT! Gastric candidiasis in 70% is a consequence of another disease, and treatment begins with eliminating the first problem. Without eliminating the root cause, antifungal therapy will not bring results.

Medication

Drugs for the treatment of gastric candidiasis can achieve the following goals:

• have a fungicidal and fungistatic effect on the fungus;
• eliminate inflammation;
• disinfect mucous membranes;
• improve microflora;
• boost immunity.

Drugs prescribed:

The main course of treatment lasts 7-14 days. After neutralizing the main part of the fungus, the doctor prescribes a repeat examination to determine further tactics.

Treatment of gastric candidiasis is a long-term undertaking, so it may be necessary repeat course with a change in the set of drugs.

Diet

Dieting is a must successful treatment. The patient is recommended:

• exclude sweets, flour, coffee, alcohol, mushrooms;
• do not eat fatty, fried, smoked foods, canned foods;
• limit the quantity pasta, white bread, potatoes;
• Beware of fruits that ferment in the intestines, for example, grapes, melon.

The following foods restore digestion:

ATTENTION! Meals are fractional, in small portions, at least 5-6 times a day. Too hot and cold food is prohibited.

Folk recipes

Traditional medicine is effective in the early stages of candidiasis. In acute forms, it does not bring benefit and delays the healing process. If the fungus has multiplied on the mucous membrane, folk remedies will have a negative impact on the patient’s condition.

The following remedies may provide some benefit at the onset of the disease:

Video: treatment of gastric candidiasis using the method of Professor Neumyvakin

The course of treatment lasts 1-2 weeks. Apply every 2-3 days. Like all non-traditional and folk methods, it requires the approval of your doctor.

CAREFULLY! Folk remedies have many contraindications, so taking them without prior consultation with your doctor is prohibited. Incorrect treatment according to the prescriptions of traditional healers can aggravate the condition and cause side effects.

Complications

The presence of fungus in the patient’s stomach leads to the most unpleasant consequences. Without treatment, the fungus multiplies so much that irreversible pathological changes in the mucous membrane develop. Extensive ulcerations of the mucous membrane can cause gastric bleeding and peritonitis.

The activity of the fungus eats away the walls of the stomach, forming ulcers and erosions.

The tissues affected by the spores die, and rotting processes begin on the mucous membrane.

The purulent masses cause intoxication of the entire body and enter the chest area.

Fungal spores enter the blood, which spreads microorganisms throughout internal organs, which disrupts their work.

Serious inflammation leads to complete disruption of the digestive process and can be fatal.

Prevention

Gastric candidiasis is a disease that is easy to prevent but difficult to cure. The main rule is not to bring the body to exhaustion and dysbiosis.

Exactly strong immunity and healthy intestinal microflora protect the body from Candida fungus. To prevent pathogenic microorganisms from having a chance to infect the intestines and subsequently reproduce in it, it is enough to follow the rules:

• accept any medicines as prescribed by a doctor and in prescribed doses;
• organize a balanced diet;
• maintain oral hygiene, wash your hands more often;
• stop smoking and drinking alcohol;
• lead a physically active lifestyle, regularly take walks in the fresh air.

IMPORTANT! People with gastrointestinal diseases are at risk of stomach damage from Candida fungus. They need to especially carefully monitor the appearance of unpleasant symptoms and immediately contact a gastroenterologist.

Gastric candidiasis requires long-term, consistent therapy, especially in advanced conditions. Improvement in health occurs within 1 to 6 months.

Getting rid of fungus in the stomach leads to a general improvement in a person’s condition.