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What is Intestinal Candidiasis? Symptoms, Causes, Diagnosis and Treatment

Vaginal yeast infections are very common, causing, on average, infection in the urogenital tract in 75% of women, at least once in their life. Even up to 10% of them present this pathology frequently. However, the Candida can cause other conditions such as intestinal candidiasis.

Candida albicans is an opportunistic pathogenic yeast that lives in the gut microbiome of humans. It is not a harmful microorganism in itself, but when a person has immunosuppression or associated diseases, it can take advantage of it to spread uncontrollably. Do you want to know more about it?

Candida overview

The genus Candida is a group of yeasts that includes more than 60 species. Almost all of them are endosymbiotic commensals of their hosts, but when internal irregularity occurs, they can overgrow and become pathogenic. 90% of the infectious pictures are caused by a specific microorganism, Candida albicans.

C. albicans causes vaginal yeast infection, which affects almost all women at some point in their life. This type of infection is common without the need for immunosuppression, since it is usually caused by the hormonal and physiological changes associated with the menstrual cycle.

Beyond its most typical variant, candidiasis can present in other forms. The muguet is the second most common clinical manifestation and represents an invasion of C. albicans in the oropharyngeal environment of the patient. As stated in the journal Annals of Pediatrics, the muguet is an almost exclusive infection of young children.

When a baby passes through the labor tract — or by consuming breast milk — it can inevitably become infected with Candida. Since his immune system is not yet fully developed, it develops a whitish, cottony-looking mouth infection. It is not a worrisome clinical entity, because with antifungals it heals quickly.

In any case, a thrush in adults could be a problem. According to studies, oral or esophageal candidiasis is usually a clear sign of the transition to AIDS in patients with HIV. When Candida settles outside the urogenital tract in a supposedly immunocompetent person, it is always a sign that something is wrong.

Possible Causes of Intestinal Candidiasis

Candida albicans can infect the oropharyngeal cavity and the urogenital tract, but it is also capable of developing in the intestinal tract, leading to “intestinal candidiasis.” Next, we present some of the possible triggers of this clinical entity.

1. Crohn’s disease

Crohn’s disease manifests itself as recurrent inflammation of certain parts of the digestive tract, especially the lower end of the small intestine. Up to 22% of patients with this condition present a significant colonization of Candida albicans at the intestinal level, as indicated by studies.

This condition is believed to arise from the imbalance between immune responses and the microbiome that inhabits the intestinal environment of the affected person. Significantly, Crohn’s patients present populations of Candida in their gastric tract, but the interaction between the two concepts has not yet been fully elucidated.

2. Ulcerative colitis

Ulcerative colitis is an inflammatory disease of the colon and rectum, with frequent symptoms in the form of diarrhea and abdominal pain. According to the aforementioned study, patients with a chronic form of this disease appear to have increased populations of C. albicans in their intestinal environment.

In addition, it has been shown that the administration of antifungals can be useful in reducing symptoms in patients with active ulcerative colitis. All of these data seem to indicate that intestinal candidiasis is more closely associated with chronic inflammatory bowel diseases than it might appear.

3. Gastric ulcers

According to studies, these yeasts infest stomach ulcers, especially those that are already clearly formed. In addition, the greater the colonization of Candida in the environment of the injury, the more difficult the general treatment will be.

4. Pathologies that cause immunosuppression

As we have said before, a yeast infection outside the vaginal environment is almost always a sign of immunosuppression. This can be derived from own pathologies or, failing that, from habits and consumption of certain drugs. We can highlight the following:

  • Consumption of corticosteroids: corticosteroid drugs are used to alleviate the symptoms of autoimmune diseases, among many other things. Due to their uses, they are considered immunosuppressive drugs.
  • Prolonged stress over time: cortisol, the stress hormone par excellence, causes immunosuppression, as studies indicate. Therefore, people with chronic anxiety and other emotional disorders tend to be more prone to infectious events.
  • Alcoholism, diabetes, smoking, and other lifestyle-related factors.
  • AIDS: the HIV infects and destroys the CD4 time, essential for the development of the immune response. If the CD4 count is less than 200 units per cubic millimeter of blood, the person goes from being infected to having AIDS. In this state of immunosuppression, Candida infection is assured.
  • Blood cancer: In some types of cancers, healthy lymphocytes are replaced by mutated and useless strains. Leukemias and other conditions can cause profound immunosuppression in the patient.

In summary, candidiasis outside the vaginal environment is caused by previous pathologies. Therefore, in addition to being a clinical entity in itself, it is considered an indication of another more serious underlying condition.

Symptoms of intestinal candidiasis

Intestinal candidiasis causes symptoms in the gastric environment, but also beyond it. Some of them are abdominal distension, colic, paleness, anorexia and irregular diarrhea (no mucus or blood), as indicated by clinical reports. Lack of food intake and dehydration can also cause fatigue, headaches, among other nonspecific symptoms.

Intestinal candidiasis inhibits the repair of lesions and inflammatory events in animal models, according to studies already cited. Therefore, beyond the invasion itself, the symptoms can be more dictated by the lack of healing of the original condition (an ulcer, Crohn’s, colitis, etc.). Knowing where the painting begins and ends is complex in these cases.

The biggest risk of yeast infection: yeast infection

Candidemia, within candidiasis, is defined as the presence of Candida albicans units in the circulatory system. In other words, this fungus enters the bloodstream and spreads to different organs of the body.

According to studies, in countries like U.S, candidemia occurs in 9 people per 100,000 inhabitants. The incidence increases over the years, as more and more patients remain alive for long periods in intensive care units with serious pathologies. The mortality rate in this clinical picture is 44%.

How can it be diagnosed?

Unlike other variants of candidiasis, this can be diagnosed by performing a stool culture, or what is the same, an analysis of the stool. Once the sample is obtained, it is isolated and incubated under specific conditions. If the fungus begins to grow (forming a cottony film), the patient is infected.

You can also go for a blood test and the quantification of immunoglobulins in the hematological profile. It is expected that, in the presence of candidiasis, IgA, IgG, IgM Anti- C. albicans antibodies will be increased.

Treatment for Intestinal Candidiasis

Finding a standardized treatment for intestinal candidiasis is complex, as it is a very rare clinical entity that is only seen in immunocompromised people or people with previous intestinal problems. Of course, once the infection is eliminated, it is necessary to treat the root problem.

A single oral dose of the antifungal fluconazole in tablet form is effective in 90% of cases of vaginal yeast infection. For the condition that concerns us here, antifungal agents are also often used, but it is necessary to vary the patient’s diet.

For example, foods with simple carbohydrates, yeasts or fermented products should be nipped in the bud, at least until the intestinal yeast infection begins to show signs of disappearing. All simple sugars are also usually restricted, since it is one of the energy sources most used by Candida to proliferate.

What is there to remember?

Most cases of intestinal candidiasis are preceded by a previous clinical entity. It is important to do regular checks once the infectious picture has ended to avoid its reappearance. Similarly, it is convenient to address its triggers, such as cancers, HIV, chronic inflammatory problems in the gut, and other entities.

Ultimately, it should be noted that little can be done to prevent a yeast infection. The best prevention will always be to go to the doctor as soon as intestinal symptoms begin to be noticed to establish a treatment as soon as possible.

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