Oral Candida

Candida Esophagitis

Candida Esophagitis

What is Candida Esophagitis?

Esophagitis happens to be a state of inflammation or irritation of the esophagus, which is the tube that carries food from the throat to the stomach. These irritations and inflammations can be quite painful and it makes almost impossible to swallow.

Candida esophagitis is an opportunistic infection occurring in oesophagus (food pipe), and is also known as monilial esophagitis / oesophageal thrush / oesophageal candidiasis. The candida species which cause this infection is naturally present in our mouth, gastrointestinal tract, vagina and as well as skin. Healthy individual are not affected by Candida esophagitis infections, and it occurs in people with compromised immunity due to various factors and underlying diseases. Sometimes it may occur in people with no risk factors and is generally asymptomatic in nature.

 

Who Can Suffer from Candida Esophagitis?

A person can suffer from Candida esophagitis infections after suffering from viral infections like HIV or AIDS, or undergoing treatment for cancer (chemotherapy), and patients who underwent an organ and bone marrow transplant. As during their illness they are on immunosuppressant medications. Individuals on kidney dialysis, or patients undergoing long term corticosteroid therapy and conditions like alcoholism, malnutrition, diabetes mellitus can lead to a compromised health status resulting in occurrence of Candida esophagitis as well. In few cases when babies are born vaginally may also develop this infection if the mother is suffering from vaginal yeast infection of Candida albicans.

 
 

What are the Symptoms of Candida Esophagitis?

  • Ulcers on the food pipe causing difficulty and pain while swallowing (eating and drinking).

  • Loss of appetite and weight loss.

  • Sensation of food sticking in neck and nausea.

  • Individual may experience burning chest pain.

  • In some cases a person may suffer from mild fever.

  • Oral candidiasis may also be present causing foul odor and bad taste in mouth.

The clinical signs of Candida esophagitis are odynophagia, concomitant thrush and weight loss.

 
 

What is the Diagnosis and Treatment for Candida Esophagitis?

Diagnosis of Candida esophagitis is initially made by a physical examination by a physician with detailed medical history. An EGD (Esophagogastroduodenoscopy) test is conducted in which the oesophageal tract is examined by endoscopy, and a tissue biopsy sample is collected during the procedure which is later examined by the pathologist to conclude and confirm the test results at microscopic level.

 

Candida Esophagitis Examination
Candida Esophagitis Examination
 

For treatment an antifungal is prescribed by the doctor to prevent the growth of the fungus and it is the first line of treatment. Depending upon the status and severity of the patient the treatment may vary. Sometimes painkillers are prescribed to ease the pain and discomfort experienced by the individual. The most commonly used drug is an antifungal called fluconazole, and other therapy drugs which can be used are nystatin, oral triazoles. Capsofungin and Amphotericin are used in systemic cases of the infection.
 

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Eosinophilic Esophagitis

Alternatively known as allergic esophagitis, happens to be an allergist, and inflammation of the esophagus and it involves Eosinophils, which are specific type of white blood cells. The typical symptom of Eosinophilic Esophagitis involves difficulties in swallowing, vomiting tendencies, heartburn, as well as food impact.

Though the trouble of Eosinophilic Esophagitis is primarily related to infants, it has however got every potential to attack adults as well. Even if the condition is not fully known, still it has been found that food allergies play a major role in triggering these issues. Usually, the treatment involves the process of the elimination of the identified or the suspected factors and the application of suitable medication for suppressing the response of the immune system. In instances of severity, it might require the care provider to enlarge the esophagus, by the application of the endoscopy procedure.

The signs and symptoms of this form of Esophagitis vary in adults and infants. In adults, the usually observed issues are difficulties in swallowing, or instances of food getting stuck in the esophagus, after swallowing, and the feeling of intense chest pain that never ever gets eliminated, even after taking antacids. In addition, adults are likely to experience persistent heartburns and catching pain in the upper parts of the abdomen. Undigested foods back flowing is also observed in these victims.

 

Following are the most commonly observed symptoms in infants:

  • Difficulties in feeding and eating

  • Persistent vomiting tendencies

  • Severe pains in the abdomen

  • Troubles in swallowing or foods getting stuck in the esophagus

  • Abrupt weight loss, malnutrition and inadequate growth

As the signs and symptoms of these ailments significantly vary in adults and infants, it is needless to say that different type of approaches is required to treat the troubles in these cases. One point will be highly relevant to state that these symptoms resemble the outbursts of various other ailments, and hence you should not approach own medication based on these signs. By taking the correct suitable medical care in a timely manner, you can certainly win over these challenges and restore back happiness in your life. Thus, the moment you see these troubles, you should rush to the doctors at its earliest.

Discussing about this type of Esophagitis, it will be relevant to refer to the observations made by the team headed by Chris A. Liacouras. The team conducted a research that involved around 400 respondents and spanning for a decade between 1994 and 2004. As per their observations, the troubles sometimes come, in a state when no major abnormalities are visible in the Esophagus. However, in some cases, major changes in the structure and shape of the esophagus were also observed. Thus, it will be right to say that the signs and symptoms of this ailment is likely to vary on a case to case basis.

 

Esophageal Varices

Alternatively known as Oesophageal Varices, Esophageal Varices are the sub-mucosal veins that are highly supple and lay in the lower 3rd region of the esophagus. In the majority of the instances, this condition is the outcome portal hypertension that happens mainly due to Cirrhosis. Patients, suffering from this ailment have strong tendencies towards bleeding. Typically, the detection of this ailment involves using the Esophagogastroduodenoscopy.
The draining of the upper 2/3rd of the esophagus involves the esophageal veins that carry the de-oxygenated blood to the azygos from the esophagus. In turn, it drains into the vena cava, directly. These veins play no part in triggering Esophageal Varices. The lower 1/3rd part of the esophagus gets drained into the lining of the superficial veins of the Esophageal Mucosa, draining into the coronary vein. The diameter of the superficial veins gets distended to the extent of 1 to 2 cm, happening in association with the portal hypertension.
The normal range of the Portal pressure usually stays around 9 mmHg, in contrary to the pressure of the inferior Vena Cava that varies in the range between 2 and 6 mHg. In instances, the portal pressure crosses the extent of 12 mmHg, the gradient range of the pressure goes to the extent of 7 to 10 HMG, compared to its normal standing in the range between 3 to 7 mmHg. When the gradient pressure exceeds the extent of 5 mmHG, Portal Hypertension takes place.
If the gradient pressure exceeds the extent of 10 mmHg, blood flows takes the path through the system of hepatic portal and gets redirected from the hepatic region to the areas having lower venous pressure. It implies a development of collateral circulation along the lower part of the esophagus, walls of the abdomen, stomach, as well as the rectum. The tiny blood vessels in this region get distended, taking a more thin-walled appearance, appearing as Varicosities.
If the Portal pressure enhances, there appears dilation of the anastomosis veins and it paves the way for esophageal varices. One of the rare conditions is that of Splenic Vein Thrombosis that triggers the emergence of this form of Esophagitis, appearing even without the enhanced portal pressure. It is likely that these troubles can appear in other parts of the body, with the stomach, duodenum and the rectum being the most vulnerable areas to get affected by Esophageal Varices.

 

Esophageal Spasm

A condition of painful contractions of the muscular tube that connects the mouth to the stomach, Esophageal Spasm can produce a feeling like severe and sudden chest pain and usually persist for a few minutes to hours. These troubles will only appear occasionally and it never ever needs any treatment. However, in some instances, Esophageal spasms can appear more frequently and block the path for foods and liquid to move through the esophagus. In such instances, the conditions are interfering with the inherent abilities, the troubles can be easily overcome with simple treatments.
Following are the most common symptoms of this type of Esophagitis:

  • Feeling of a squeezing pain in the chest that often intensifies and gives a common misunderstanding for heart pain.

  • You are likely to experience troubles in swallowing specific items like extremely hot or cold foods and liquids.

  • A feeling that something has got stuck in the throat.

  • Backflow of the foods and liquids through the esophagus.

Speaking of the probable causes that trigger these ailments, though not much information have been explored till date, however, in the majority of the instances, this condition happens due to the malfunctioning of the nerves, monitoring the muscles involved in swallowing.
Individuals, having the habit of eating or drinking excessively hot or cold foods and liquids, or consuming red wine in excessive extent as well as those individuals, suffering from excessively high blood pressure, anxiety and depression, are more vulnerable to catch this ailment. Hence, these individuals need to stay more careful than their counterparts, not having the history of these instances.

If adequate medical care is approached in a timely manner, the troubles with Esophagitis will hardly ever turn crucial, and you can expect to get complete freedom to these problems within the shortest time span.

 

Study Evidence on Risk Factors of Candida Esophagitis in Outpatients and its Effective Treatment in Aids Patients

A study was published in June 2003 by the ‘Journal of International society for Disease’ of oesophagus in which patients were analyzed to determine the predisposing factors of Candida esophagitis. In brush cytology results fungus mycelia was found. During the study many predisposing risk factors like acid suppressive therapy, gastric surgery, mucosal barrier injury, steroid use, diabetes, antibiotic and rheumatologic disorders were determined. Candida esophagitis was less observed in associated malignancy. Most of the patients had more than one risk factor associated and 56% patients were treated with antifungal therapy.

Another study was conducted by “American Gastroenterological Association” in AIDS patients to demonstrate and analyze the pharmacological treatment of Candida esophagitis. In this study two antifungal drugs Fluconazole and Iitraconazole were used on two groups of HIV positive patients for a period of one year to establish the long term therapeutic efficacy of these drugs. At the end of follow up it was concluded that both drugs are efficient in treatment of the Candida esophagitis but fluconazole provided higher rate of cure as compared to Iitraconazole.

Above studies indicate that Candida esophagitis is an opportunistic fungal infection which is treatable and is linked to patients with compromised immunity and patients exposed to multiple predisposing risk factors. In both the studies patients were treated using antifungals. Even in AIDS patients fluconazole is effective and has lower failure rate in comparison to Iitraconazole thus proving fluconazole to be a better drug of choice in people suffering from it.

 
 

Prevention and Prognosis of Candida Esophagitis

In order to prevent the reoccurrence or occurrence of the disease individual must maintain good oral hygiene, use mouth washes and rinse the mouth after sugary and starchy meals. Patient should take the prescribed medications timely. Prevention can be attained by treating the risk factors and chronic diseases resulting in Candida esophagitis.

The prognosis of Candida esophagitis is good and the treatment by fluconazole is highly effective in patients. Though prognosis may be less in immune-compromised individuals and individuals with complications like narrowing of oesophagus, perforation of oesophagus, spread of infection to other sites of body and side effects or allergic reaction from the antifungal medications used for the treatment.

 

References:
Clinical findings for Candida esophagitis – Diseases of the Esophagus Journal – 2003 – By J. A. Underwood, J. W. Williams & R. F. Keate
http://onlinelibrary.wiley.com/doi/10.1046/j.1442-2050.2003.00305.x/full

 

Fluconazole versus itraconazole for Candida esophagitis – Gastroenterology Journal – 1996 – By Barbaro G, Barbarini G, Calderon W, Grisorio B, Alcini P & Di Lorenzo G
https://www.ncbi.nlm.nih.gov/pubmed/8898629

 
Eosinophilic Esophagitis (10-Year Experience in Children) – Clinical gastroenterology and hepatology Journal – 2005 – By Chris A.Liacouras, Jonathan M.Spergel, Eduardo Ruchelli..
http://www.cghjournal.org/article/S1542-3565(05)00885-2/abstract

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Candida Definition

Candida Definition

What is Candida? Definition:

When it comes to Candida definition is not hard to find because of its terrible influence in virulent forms. Candida, a genus of yeasts, has made its mark in history of common fungal infections for decades. There are species of this yeast genus, which by Candida definition, are part of the human microflora and there are some which finds good use in commercial purposes. Then there are those that can cause great discomfort to us when they transform into their virulent forms. To be precise, there are Candida species which even after being a common resident of the human microbiota can give rise to Candidiasis. These commensals take great advantage when the human immunity is suppressed or compromised one way or the other and divide rapidly, there by casing overgrowth and secrete toxic substances that give rise to discomfort.

Candida albicans is one such species that is present in mammalian hosts and can greatly help with Candida definition, while some of the others belonging to the same genus live endosymbiotic lifestyles in insects. Some of the major cause of concerns with this genus includes systemic infections mainly caused in the blood stream and deep organ tissues and mostly choose immunocompromised patients as their victims, due to weak immunity.

 
Candida Definition
 

Candida albicans is a species of fungus which can be found on the skin and within the mucous membrane. It is also found in the human gut, mouth, and vagina. This Candida yeast also can also get into the blood stream through wounds, and can also affect the intestines, genitals, throat, and body organs. Candida albicans can only cause trouble when the environment in the body changes, which leads the fungus to quickly grow out of control. Candida definition of its infection can be described as a state where the resident microorganism takes a virulent form when its environment is to its liking. Another way of defining Candida is that it is regarded as a highly opportunist fungus, as it can easily spread from one part of the body to another.

 

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Where Do Candida Infections Occur?

Candida definition of the infection can see this fungus occur commonly in the mouth, skin, or genitals. But sometimes it has no particular reason why it can occur, other than recent antibiotic use, which destroys the healthy microorganisms within the body, and this leads to multiplication of the fungus.
 

Candida definition can be recognized in its truest sense when its common symptoms start showing. Here are some of the areas it can affect:

  • This infection can be seen on skin as a red and inflamed, with some rashes.

  • Can cause vaginalitis moniliasis, a Candida infection generally found in vagina.

  • It can also infect the nails.

  • It can affect the digestion process in the intestine.

Candida infection is more common in men with an uncircumcised penis than in those with an circumcised penis, and it may sometimes get contracted during intercourse with a partner that is infected.

In some cases such as aids and leukemia when resistance of the body is low, the candida fungus can enter into the bloodstream and can cause infections in the organs.

 

How Antibiotics Promote Yeast Infection?

Candida definition can get real simple when antibiotics come into play. This is because these medications have the potential to kill the good bacteria that keeps Candida and other yeasts in check. With prolonged use, it can be the major cause of Candida overgrowth and perforation of the mucosa layer as well. Most women get easily affected with Candida in comparison to male, especially in the genital area.

 

How Immunosuppressant Promote Yeast Infection?

A recent study published in 2011 analyzed the colonization effects of Candida in the GI tract and it’s relation with inflammation. It showed that when human patients were administered Lactobacillus acidophilus, their symptoms reduced, and in case of mice with ulcers, when acetic acid was administered the size decreased. This helped to conclude that as Candida albicans colonization slows down the healing process, it is hard for patients to recover, especially with the administration of antibiotics and immunosuppressant.

This study gives a clear perspective why patients receiving treatment with immunosuppressant and antibiotics take more time to heal from Candida colonization. It is easier to maintain the human microbiome without the administration of such medicine which delays the healing process.

 

Symptoms of Candida

Confused about Candida symptoms? Candida definition can set it straight. This is so, because it has a very distinct characteristic symptom for each infection, which helps in defining it.

  • A thrush also known as oral Candidiasis is accompanied by creamy white patches, which can be inflamed sometimes. This is found on the tongue or throat part of the oral cavity.

  • Scaly skin with a reddish coloration can be a symptom of diaper rash often caused by Candida.

  • Candida vaginitis is one such disease that is very common in woman. Its characteristic symptom is yellowish white discharge. It also leads to inflammation of the vaginal walls, the vulva are the external genitalia and is often accompanied by a burning and/or itching sensation.

  • Pus development is also a symptom when Candida causes toe nail or finger nail infection. At first it gets inflamed and turns red, followed by pus development if left untreated.

  • The penis head gets all red and inflamed when Candida causes balanitis.

  • Systemic infections (in bloodstream) can cause deep organ damage including the heart, eyes, kidney and lungs.

  • It can cause blood to appear in urine, when kidney is affected.

  • For the heart, murmurs are accompanied by valve damage.

  • It can get real painful with the eyes, leading to blurred vision.

  • Acute seizures and changes in mental functioning is a direct cause of brain damage by Candida.

 

An article published in 2013 aiming to find the pathogenicity mechanism of Candida albicans stated that although Candida albicans is a normal microorganism of the human microbiome, when there are environmental factors present, then it can metamorphose in to their virulent form. Some of these virulent forms as identified through the study are biofilm formation, secretion of hydrolases, contact sensing, pH sensing and their ability to adapt to a the internal environment of the host body. It concluded that although the anti-fungal drugs at present work just fine when the virulent factors that lead to hypha formation are targeted, better therapeutic methods could be added to the list of treatments.

This study shows that tackling the issues of Candidiasis can get easier with time and knowledge of the virulent factors of Candida sp. It also goes to show that having better therapeutic methods to deal with Candida is necessary and is possible.

Candida definition is hard to describe when the symptoms aren’t clear which is why treatment normally begins quite late in the entire process of colony formation. Candida treatment can be done at home with prescribed medication. In this, topical antifungal medication such as tioconazole, clotrimazole, nystatin, miconazole or orally administered drugs like fluconazole and amphotericin B are used. Women generally prefer taking fluconazole when they have vaginal Candidiasis, instead of using topical creams. Most of the times antifungal drugs clears the trouble, but this infection can also recur sometimes by having sexual intercourse with an infected partner. It is advised to discontinue the use of antibiotics during a fungal infection as it can trigger the breeding of infection. But one must first consult their doctor before discontinuing any prescribed medication. For infants suffering from diaper rashes, barrier creams and changing the baby’s diaper frequently can be of great help in order to deal with the infection. Those with a tendency to get affected with Candidiasis of the skin should try to keep their body’s skin dry. It is essential to wear loose clothing, ideally made from cotton, and maintain good hygiene.

 

References:

Candida albicans pathogenicity mechanisms – Virulence Journal – 2013 – By François L. Mayer,  Duncan Wilson, Bernhard Hube
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654610/

 

Inflammation & gastrointestinal Candida colonization – Current Opinion in Microbiology Journal  – 2011 – By Carol A. Kumamoto
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163673/

 

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