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Everyone knows about the fungi attacking the skin, especially around the feet of people using public swimming pools or saunas. Ladies certainly know the fungus of intimate areas from the stories of their friends or from the autopsy. Some people probably know that the common dandruff is also caused by a fungus.
Fungi can cause serious infections of the lower respiratory tract and the brain. These pathogenic microorganisms are able to attack every corner of the body, including the digestive tract, which, due to its function and structure, is a very favorable habitat for fungi.
The most common fungus in the digestive tract is Candida albicans, but there are also other species, such as: Candida tropicalis, C. krusi or C. parapsilosis. Infections caused by fungi belonging to the species are less common Aspergillus.
The physiological flora of the digestive tract
Briefly about the anatomy of the digestive tract: the oral cavity; throat; esophagus; stomach; duodenum; small intestine; small intestine; large intestine (colon); rectum and anus. Each part of the digestive tract can be attacked by pathogenic fungi – this condition is called candidiasis. The matter is complicated by the fact that mushrooms of the genus Candida belong to the so-called the physiological flora of the digestive tract, which means that they can be naturally present in certain amounts and not cause symptoms of the disease. Fungal infections of the gastrointestinal tract are called opportunistic infections, i.e. those caused by microorganisms that naturally colonize the body without causing problems, but attack when immunity decreases. In such a situation, their number increases rapidly and the symptoms of the disease appear.
Read more: What lives in a person?
Risk factors for the development of candidiasis
As you can guess, there are certain conditions in which the body is found that predispose to the occurrence of mycosis of the gastrointestinal tract, they include:
- any immunodeficient diseases such as AIDS
- administration of immunosuppressive drugs (reducing immunity), e.g. after organ transplants
- diabetes
- an ongoing neoplastic process
- cytostatic (anticancer) treatment
- radiotherapy
- long-term use of drugs that reduce gastric acidity during the treatment of peptic ulcer disease
- long-term oral antibiotic therapy, especially with broad-spectrum antibiotics
Symptoms of mycosis of the gastrointestinal tract
It is easiest to tell oral and anus mycosis due to the fact that it is enough to see the area with the naked eye. Ringworm appears as a white coating on the mucosa or skin. Other parts of the gastrointestinal tract are available only through specialized examination, such as gastroscopy in the case of mycosis of the esophagus and stomach or colonoscopy in the case of mycosis of the large intestine. The small intestine is basically still out of reach, although there is a camera capsule technology that takes pictures as the camera travels through the gastrointestinal tract, but there is no way to take a sample for testing.
Oral mycosis often occurs in young children who are treated with antibiotics or are immunocompromised by a viral infection, for example. In the elderly, it can occur when there are dental prostheses in the mouth. Radiation therapy around the face also predisposes to fungal infections.
Esophageal mycosis it is visible during gastroscopic examination as white deposits covering the inflamed mucosa of the esophagus. Symptoms are nonspecific and may indicate many other esophageal ailments: difficult and painful swallowing; soreness behind the breastbone and / or around the spine or back. Oesophageal mycosis most often coexists with oral candidiasis.
Stomach mycosis is being recognized more and more. This is probably related to the spread of anti-ulcer therapy. This treatment involves the long-term administration of drugs to raise gastric pH and antibiotics to eliminate bacterial infection. Helicobacter pylori, causing stomach ulcers. Increasing the pH and administering antibiotics promotes the growth of fungi. The endoscopic image may show whitish or gray membranes covering areas of the gastric mucosa or the so-called fungal ulcers, i.e. classic ulcers, but with a fungal infection in their area. Stomach mycosis manifests itself with abdominal pain, nausea and weight loss. Symptoms are non-specific and require differentiation from other diseases such as gastric cancer.
Mycosis of the intestines is a problem that poses a greater diagnostic challenge due to the location that is difficult to access – the colonoscope is able to cover only the colon. The doctor performing the examination may see white patches and inflamed mucosa, which may indicate an ongoing inflammatory process of fungal etiology. Patients complain of cramping abdominal pain, diarrhea or constipation, gas and gas. Accurate diagnosis is required to exclude other serious diseases with identical symptoms and differentiation with irritable bowel syndrome. The presence of fungi in the intestines can cause disorders of the immune system and possibly also chronic fatigue syndrome.
Treatment of gastrointestinal candidiasis
The consumption of large amounts of simple sugars predisposes to mycosis of the gastrointestinal tract (especially mycosis). Mushrooms of the genus Candida like sugar, therefore in the treatment of candidiasis it is recommended to eliminate simple carbohydrates from the diet. You should also use antibiotics wisely to avoid using them when they can be avoided. If it is necessary to administer antibiotics orally, especially with a broad spectrum of activity, it is important to administer probiotics simultaneously, which will stabilize the flora of the digestive tract and reduce the risk of mycosis development. Long-term treatment with high doses of antibiotics requires prophylactic administration of antifungal drugs.
The diagnosis of mycoses of the gastrointestinal tract cannot be limited only to the visual assessment of the affected areas. The physician should take a sample and send it to a microbiological laboratory to confirm the diagnosis and determine the species of fungus and its resistance to drugs.
Text: Tomasz Gosiewski, MD, PhD