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Treatment of the fungus of the esophagus folk remedies. Mycosis of the esophagus: the main causes and treatment. Herbs for urinary tract infections

From this article you will learn: what is esophageal candidiasis, how dangerous the disease is, how the infection enters the esophagus. Causes and factors contributing to the development of candidiasis, the severity of the disease. Symptoms, treatment and diet.

Article publication date: 10/30/2017

Article last updated: 11/28/2018

Candidiasis of the esophagus is a disease of the mucous membrane of the organ, provoked by fungi of the genus Candida.

Candida is a constant companion of a person, 1–2% of fungal cells can be found on the mucous membrane of any organs and skin surface. It acquires pathogenicity against the background of a weakening of general and local immunity, when favorable conditions are formed for its active reproduction.

How does this happen with esophageal candidiasis? Under the influence of various factors (medication, age, congenital and acquired immunodeficiency, nutritional deficiencies, etc.), a number of interrelated reactions occur in the human body (decrease in the acidity of the digestive juice, electrolyte imbalance, inhibition of beneficial intestinal microflora), which lead to weakening protective functions of mucous membranes.

These changes become the starting point for the development and reproduction of Candida, its cells attach to the mucous membrane, germinate inside and quickly spread over the surface. In the process of development, colonies of the microorganism form spots, growths and films, consisting of fungal cells, remnants of the destroyed epithelium and waste products of the microorganism.

The disease is very dangerous, the fungus of the esophagus is not an independent and isolated pathology. In most cases (97%), it appears as a complication of a systemic infection that has captured the entire digestive tract and other organs. Candidal infection of the esophagus is difficult to treat, creates difficulties with swallowing and passing food (due to numerous films and growths of Candida), can be complicated to necrosis or rupture, lead to candidal sepsis (infection of the whole body) and death in 34% of cases.

It is possible to completely cure esophageal candidiasis only at the beginning of the process (in 65–70% of cases), until the fungus has penetrated into the deep layer of the mucosa, vascular system and muscles (grade 1). At other stages, the prognosis for recovery depends entirely on the state of immunity and adequate treatment.

The structure of the wall of the esophagus. Click on photo to enlarge

If you suspect candidiasis, you should consult a gastroenterologist. Consultation with an infectious disease specialist may be required.

How fungus gets into the esophagus

Microorganisms of the genus Candida that can cause fungus of the esophagus and other diseases (oral cavity, genitourinary system, internal organs, skin and nails), are constantly present on the mucous membranes inside the body or get inside with food, by direct contact with the carrier (for example, by kissing) .

With candidiasis of the esophagus, the intestine becomes the main source of fungal infection, from where it “rises” up the digestive tract and stomach (ascending route of infection).

The structure of the gastrointestinal tract. Click on photo to enlarge

At the same time, there is an active colonization of the nearest mucous membranes by fungi that get inside from the oral cavity (with vegetables and fruits, sweet sour-milk products, etc.) (descending path).

Under normal conditions, the body's immune defense restrains the pathogenicity of the microorganism (its ability to grow and reproduce, master the host tissues), in favorable conditions for the fungus, any number of cells can attach to the mucosa and form a colony, a focus of candidiasis.

Causes of esophageal candidiasis

The main cause of the disease is a systemic fungal infection of the digestive tract, pathology occurs as one of the complications.

Esophageal candidiasis is always the result of a weakened immune system, but in this case, its appearance indicates a combination of factors that caused serious and severe violations of the immune defense (for example, oncopathology and treatment with cytostatics).

What can trigger the appearance of candidiasis of the esophagus:

• congenital and acquired immunodeficiency (HIV infection);
• age-related deficiencies in immunity (newborns and the elderly after 60–70 years);
• the use of drugs (antibiotics, glucocorticosteroids, antacids that reduce the acidity of the stomach, cytostatics, chemotherapy and radiation therapy);
• diseases of the digestive tract in combination with low acidity, insufficient motility, narrowing of the lumen of the esophagus, etc.;
• endocrinopathy (diabetes mellitus, hypofunction of the thyroid and parathyroid glands, diseases of the adrenal glands);
• any severe and prolonged illness;
• transplantation of organs and tissues (and associated with the recovery period of immunosuppressive therapy that suppresses the immune response of the body);
• hypovitaminosis, anemia, metabolic disorders (calcium and phosphorus);
• irrationally composed diet (low calorie content of food, lack of proteins, excess of fast carbohydrates);
• intravenous and intragastric administration of supporting substances and mixtures (when the patient is unable to eat on his own, for example, in a coma);
• regular alcohol intoxication.

The fungus willingly masters the surface damaged as a result of injuries (accidental scratches, damage) or burns (hot drinks, chemicals).

Three degrees of disease

How esophageal candidiasis will proceed depends on the spread of infection through the mucosa, the area of ​​the affected surface, the penetration of Candida deep into the epidermis and other tissues. The combination of these factors determines the severity of the disease.

Degrees of candidiasis	Localization and manifestations of infection
1 degree	The fungus invades the cells of the surface epithelium, forming rare whitish cobwebs, spots and islets scattered along the mucosa of the esophagus.
2 degree	Pathogenic forms of Candida (elongated cells, pseudomycelium) grow deep into the mucous membrane, one by one capturing its layers Extensive, overgrown films and a fungus plaque appear on the inner surface
3 degree	The fungus develops vessels and tissues located outside the esophagus The process is accompanied by the appearance of necrotic ulcers (areas of dead tissue), complicated by the addition of a bacterial infection (phlegmon), bleeding from blood vessels and ruptures of the damaged mucosa In the lumen of the organ, in addition to the merged plaque and the islets of the fungus protruding above the surface, numerous films (pseudomembranes) are formed that block the lumen of the esophagus and make it difficult to swallow

Phlegmon

Characteristic symptoms

The severity of symptoms is almost unrelated to the severity of the disease - clear signs may appear at the very beginning of the process or after the fungus grows so much that it physically interferes with the normal functioning of the esophagus.

In 25-30% of patients, the disease proceeds without any symptoms and until a certain point (until the fungus captures most of the organ) does not affect the patient's well-being.

With a large-scale spread of infection, the patient has difficulty swallowing food. The process becomes painful, at the same time an aversion to food develops, nausea and uncontrollable vomiting of curdled contents and candidal films appear.

The further development of the disease is accompanied by acute poisoning with fungal toxins, fever (sudden temperature jumps up to 39-40 ° C), stool disorders (diarrhea with blood and mucus), and a sharp weight loss caused by aversion to food. The patient moves little due to physical exhaustion and general intoxication.

Toxins secreted by Candida. Click on photo to enlarge

Esophageal candidiasis is accompanied by more or less pronounced manifestations of diseases of the gastrointestinal tract:

• gastritis;
• duodenitis;
• enterocolitis;
• dyspepsia with indigestion, bloating, belching, heartburn, nausea, diarrhea with blood and mucus.

Against this background, there are some symptoms characteristic of a fungal infection of the esophagus:

Difficult, painful swallowing.

Decreased appetite to its complete absence.

Weight loss, physical exhaustion, dehydration.

Indomitable vomiting with the release of numerous whitish films or curdled contents of the esophagus.

Non-swallowing pain and heaviness behind the sternum.

Organ obstruction.

Fungal disease of the esophagus is complicated by:

• accession of a secondary bacterial infection and the development of acute purulent inflammation (phlegmon);
• vascular bleeding;
• breaks (perforations) of the organ wall;
• candidal sepsis (large-scale inflammation in response to a spreading fungal infection) and death as a result.

Diagnostics

Diagnosis of candidiasis is carried out using esophagoscopy, a method using a special optical device. It allows you to assess how affected the mucosa of the esophagus.

Esophagoscopy process

Characteristic signs of candidiasis during esophagoscopy:

• On the mucosa there is a whitish or yellowish coating in the form of cobwebs, loose rounded or oval plaques, grayish fringed ribbons.
• The inner surface is edematous, red, easily injured and bleeds.
• Ulcers and erosions of various sizes are found under the plaque.

To determine the localization, type of fungus of the esophagus and its sensitivity to medicines:

A scraping of the mucosa (biopsy) taken from the esophagus is stained with a special cytological brush (it is inserted through the mouth or nasal opening). With a positive result, round or oval Candida cells and filamentous pseudomycelium are found in the smear.

Biological material (piece of tissue, biopsy specimen) is stained with special dyes (CHIC reaction for mucopolysaccharides), determining how deeply the fungus has invaded the esophageal mucosa.

The material is sown (scraping from the walls) in a nutrient medium, determining the degree of sensitivity (treatable) or resistance (not amenable) of the fungus to various medicines.

Treatment Methods

Complete cure of candidiasis is possible with grade 1 in 65-70% of cases. With grades 2 and 3, the outcome depends on the severity of the concomitant disease, the state of the body's immune defenses, the correct treatment regimen, and the sensitivity of the fungus to the prescribed drugs.

For the treatment of the disease, a complex is prescribed, consisting of a combination of different antifungal agents (triazoles, polyene antibiotics, imidazoles) in the form of tablets and solutions for administration (intravenously, intramuscularly).

The duration of treatment, the combination and dosage of drugs depend on the severity of the disease. Usually the doctor selects them individually.

What drugs are used to treat esophageal candidiasis:

Drug group	Name and form of the drug
Imidazole derivatives	Ketoconazole (Oronazol) tablets
	Clotrimazole (Imidil, Candide) liquid and spray for irrigation
	Miconazole (Daktotsin, Daktanol) in injections
Triazole derivatives	Fluconazole (Forcan, Diflucan, Fucis) tablets or liquid for injection
	Itraconazole tablets and oral solution
Polyene antibiotics	Amphotericin B (Ambizom, Fungison, Amphocil) in solution for intravenous drip
	Nystatin (Fungicidin, Mycostatin)
	Caspofungin in solution for intravenous administration

The complexity of the treatment lies in the rapid decrease in the sensitivity of the fungus to certain drugs. Because of this, it is recommended to increase the medicinal dose of drugs, change the form of the drug (from tablets to injections) and move on to another medication in the series.

Diet

During the treatment of the disease and during the recovery period, patients are advised to adhere to a strict diet.

In the acute (with difficulty swallowing and pain) and recovery period, dishes (and drinks) should be:

• warm (not higher than 40 ° C);
• soft (boiled cereals, pureed vegetables, meat, mucous soups, mashed potatoes);
• sparing (not irritating to the mucous membrane, without pepper, vinegar, any seasonings).

Diet for esophageal candidiasis should include	Completely excluded from the diet
Lean meat (veal, rabbit, chicken) and fish	Jam, honey, sugar syrups, sugar and its substitutes
Offal (liver)	Confectionery, muffins, white bread
Cabbage, carrots, wheat germ, cucumbers, asparagus, spinach, lettuce	Candy and chocolate
Green apples, plums	Fresh milk
Walnuts	Potato, starch, sugar beet, rice
Beans, beans, lentils, chickpeas	Kvass, alcohol and beer, carbonated drinks, nectars and juices with fruit pulp
Millet, oatmeal, buckwheat, brown rice	sweet fruits
Homemade fermented milk products with beneficial lactobacilli	Chips, nuts, semi-finished products, smoked products, canned food
Eggs
Butter and vegetable oil
Seasonings: ground cinnamon, cloves, bay leaf
Onions and garlic (as prebiotics, during the recovery period)

Coffee can be replaced with a weak chicory drink, black tea with green tea, rosehip or chamomile decoction without sugar.

Click on photo to enlarge

Forecast

The prognosis for the disease depends entirely on the severity of the disease. At grade 1, until the fungus has slightly mastered the mucosa of the organ and has not penetrated into the deep layers of the epidermis, treatment may take from 3 weeks to 2 months. Complete cure occurs in 65-70% of cases.

The second and third degrees of esophageal candidiasis are much more difficult to treat and take longer. Typically, these forms of fungal infection develop against the background of serious immune disorders (HIV, oncology). To eliminate them, it is necessary to get rid of the underlying disease, and this is not always possible.

As a result, in 34–36% of patients, a fungal infection of the esophagus is complicated to a systemic, generalized process with a fatal outcome.

Owner and responsible for the site and content: Afinogenov Alexey.

An infectious lesion of the esophageal tube with the active action of a fungus of the genus Candida, from which the origin of the diagnosis is taken, is called candidiasis. According to the international classifier of diseases of the 10th edition, pathology refers to an unspecified disease of the esophagus.

The disease code according to the international classifier is K22.9.

Photo of candidiasis of the esophagus

The disease has a long period of treatment, with insufficient adherence to the diet, daily regimen and treatment regimen, the success of recovery is in question. Patients suffering from pathologies of the digestive system, in the amount of 1.5% of the total number of cases, candidiasis of the digestive system is detected.

The onset of the disease is facilitated by a failure of immune reactions, activation of the human immunodeficiency virus, and impaired intake of antibacterial agents.

Causes and factors of occurrence

Fungi of the genus Candida are in different organs of the gastrointestinal tract in a passive state in a healthy person.

Studies have found their presence in 8 healthy people out of 10 with localization in the intestinal cavity, in every fourth subject - in the oral cavity. When favorable conditions occur, Candida fungi begin to actively reproduce, being a pathogenic environment for many functional systems and causing corresponding disturbances in them.

Esophageal candidiasis develops when activated infectious agents enter the tube cavity from the oral cavity (downward current) or from the gastrointestinal area (upward current).

In the environment, fungi from the genus Candida are common, for this reason it is not difficult for them to spread into the human body. This happens frequently under the following circumstances:

• contamination of used food products;
• various contacts of people, one of which is infected with fungi;
• contact with household items used by an infected person.

Rarely, only the walls of the esophagus are affected by a fungal infection; in most cases, esophageal candidiasis is part of the overall clinical picture with damage to several organs of the gastrointestinal tract.

The main optimal condition for the activation of the fungus of the genus Candida is to reduce the body's immune responses. Most patients with diagnosed esophageal candidiasis are children with incomplete immunity and people of mature age with immunodeficiency.

A number of endogenous and exogenous factors increase the risk of developing esophageal pathology with activation by a fungal infection. These include:

• hypoparathyroidism and hyperparathyroidism;
• repeated toxic reactions of different genesis of the organism;
• hormonal abnormalities due to impaired secretion of catecholamines, mineralocorticoids and glucocorticoids;
• frequent allergic reactions of the body;
• diabetes mellitus of all types;
• increase in acid-base balance of gastric juice;
• insufficient patency of the esophagus;
• transplantation of organs and tissues;
• nutrition of enteral and parenteral types;
• deviations in the motor reaction of the esophagus;
• corticosteroid injections or corticosteroid solutions in inhalers;
• chronic effect of infection (Koch's wand);
• protein deficiency in the body;
• prolonged use of antibacterial drugs;
• antacid therapy.

The esophagus shows the content of mycelial hyphae in samples of affected tissues. A similar histological condition of the esophagus is preceded by a weakening of the immune system.

Symptoms of candidiasis of the esophagus

The initial stage of development of esophageal candidiasis is not accompanied by clinical signs and pathological sensations of patients. Superficial penetration into the tissues of the esophagus, sluggish clinical picture, low severity of the disease accompany the diagnosis of "esophageal candidiasis" in 3 patients out of 10.

The main signs of esophageal candidiasis noticed by the patient are as follows:

• discomfort (often pain) in the area of ​​the diaphragm;
• subfebrile temperature;
• deviations in the normal act of swallowing;
• heartburn of varying degrees of sensation;
• chest pains;
• liquid feces interspersed with blood clots and mucus-like fragments;
• reduced or absent appetite;
• pain when trying to swallow, leading to exhaustion or dehydration, which is typical for a severe degree of development of the disease, when it becomes impossible to swallow water;
• frequent nausea, the presence of mucus is noticeable in the vomit.

Lack of treatment complicates the disease and creates conditions for the penetration of activated forms of Candida into the gastric walls, although without severe pathological processes in the stomach (operability, ulcerative necrotic phenomena), such a process is extremely rare.

The increased formation of mucus and its accumulation on the walls of the esophagus creates additional difficulties with the passage of food through the hollow tube.

The highest picture of symptomatic manifestation of esophageal candidiasis are the following signs:

• with or without perforation;
• damage to the blood vessels supplying the muscles of the esophagus.

During endoscopic examination of the esophagus, its walls in the initial stages appear with a changed color range to yellowish or whitish, with convex areas. Later, colonies of multiplied Candida fungi are added to the affected foci, subsequently penetrating into the submucosa.

Laboratory studies of the microflora of the affected areas showed the presence in the tissues of not only fungi of the genus Candida, but also pathogenic bacteria.

Diagnostics

Recognition of the disease begins with an anamnesis of data, where the patient describes complaints about the disease that have arisen recently. The main instrumental method for detecting esophageal candidiasis is esophagoscopy.

Endoscopic studies reveal hyperemia of the affected areas of the esophagus, fibrous plaques, and rapid vulnerability when in contact with instruments.

When the disease manifests itself, 3 forms of esophageal candidiasis are distinguished:

1. Pseudomembral esophagitis, in which the affected surface of the esophageal mucosa is accompanied by the formation of plaques. Attempts to penetrate instruments along the wall of the esophagus lead to wounds.
2. Erosive esophagitis of fibrinous type. The endoscope is sometimes impossible to advance along the walls of the esophagus due to its stenosis. The surface of the lesion differs from type 1 esophagitis by the presence of gray fringed bands. Mucous edematous, hyperemic over the entire surface.
3. catarrhal endophagitis. The mucosa in this form of the disease is slightly reddened, swollen. The affected areas look like a spider web.

If it is impossible to insert a catheter through the mouth opening, they try to penetrate it through the nasal cavity. An endoscope is inserted into the catheter. After removing the catheter with the endoscope, the liquid left on it is subjected to laboratory microscopic analysis.

If a mycelium is found in the biopsy, fungi are sown and exposed to the main groups of drugs used in the treatment of esophageal candidiasis. A drug that has found low resistance to Candida is prescribed for subsequent use.

Treatment

Medicines

1. Therapeutic treatment with antifungal agents (Fluconazole, Oranazole, Nizoral, Miconazole, Clotrimazole). Each of these drugs has features of use: pregnancy, children under 4 years of age, liver failure, accompanying the disease with high testosterone levels, etc.
2. Enterosorbent therapy to facilitate the release of toxic products (Atoxil, Polyfepam, Enterosorb, Polysorb, Antralen, Enterosgel).

Folk remedies

As an external use, rinse the mouth after eating with a solution of baking soda. Orally, infusions of herbal remedies (St. John's wort, common calendula, chamomile, oak bark) are used.

Diet food

To increase the balance of microorganisms in the gastrointestinal tract, foods rich in useful prokaryotes are used in dietary nutrition: lactic acid products, pre-fermented vegetables, kombucha.

From fresh products or their decoctions, cabbage, rose hips, rice, onions and garlic are more often included in the daily diet.

With caution and minimal inclusion in the daily menu, sweet, spicy, pickled, canned foods are used. Carbonated drinks and confectionery are excluded.

Forecast and prevention

Esophageal candidiasis can be cured with a combination of several methods of treatment and adherence to a treatment regimen for a long time.

Preventive measures to prevent esophageal candidiasis are divided into 2 areas:

1. General strengthening measures to increase immunity.
2. Special prophylaxis, including mainly dietary nutrition.

Esophageal candidiasis is considered one of those diseases that always accompanies HIV infection. But in fact, everything is much more complicated, and often it can be a completely independent form of the disease, which is also more dangerous than all other types of candidiasis. After all, the disease affects the internal organs, and it will be difficult to cure it. In order for the treatment to be effective, you need to find out what factors cause candidiasis, how it develops and what needs to be done to stop this disease with minimal consequences for the body.

Factors provoking the development of esophageal candidiasis

The main reason for the development of any form of candidiasis is the insufficiency of the body's natural immune defenses. That is why this disease accompanies HIV. And this applies to those cases when HIV is already in the terminal phase. But it can also be caused by other factors, including:

1. Physiological decrease in immunity. This happens during stressful conditions, as well as during pregnancy, in addition, there is the concept of senile immunodeficiency and a similar disease that is characteristic of infants, that is, they can be of an age-related nature.
2. Congenital immunodeficiency diseases.
3. Oncological diseases, including hemoblastoses, as well as esophageal candidiasis, occur as a consequence of chemotherapy, since at this time the natural immunity of a person is suppressed.
4. Autoimmune diseases and allergic reactions. Sometimes candidiasis develops as a response to glucocorticosteroid therapy.
5. Organ transplantation.
6. Endocrine disorders, including diabetes mellitus.
7. Other diseases, including hepatitis, chronic infections, liver pathologies.

In addition, esophageal candidiasis can be caused by prolonged antibiotic therapy, since such drugs usually upset the balance in the natural biocenosis of such systems. They kill all microflora, including useful ones, and this becomes an impetus for the increased development of opportunistic microflora, including fungi of the genus Candida, which are the causative agent of this disease.

An unbalanced diet can also lead to esophageal candidiasis. Here the main problem is associated with insufficient intake of proteins and vitamins in the body.

Signs of candidiasis of the esophagus

Symptoms of esophageal candidiasis largely coincide with the signs of its other forms. For example, or the stomach manifests itself in much the same way, although it is much less common. The fact is that fungi of this species most often prefer areas with stratified epithelium, as in the esophagus or in the mouth, and less like mucous membranes, as in the stomach. At the initial stage of the disease, the symptoms of candidiasis are almost invisible, and many take them for signs of a general malaise. In the presence of immunodeficiency, their clinical picture is indeed blurred.

Sometimes the signs of candidiasis manifest themselves in such a way that they rather resemble a peptic ulcer or other gastrointestinal disorders. Moreover, ulcerated walls of the mucosa remain from them. That is, whenever there is at least some suspicion that this is esophageal candidiasis, it is necessary to seek the advice of a doctor. The specialist will be able to make a diagnosis, focusing not only on the clinical picture, but also on the data of additional examinations.

Symptoms of candidiasis in such cases are reduced to the fact that:

1. The patient feels the presence of pain behind the sternum.
2. Appetite is disturbed, at first glance - for no reason.
3. There is dysphagia, that is, difficulty in swallowing food.
4. Odynophagia is possible, that is, even painful sensations when swallowing. Moreover, the pain can be both in a strongly pronounced, and in a rather weak form, on the verge of ordinary discomfort. If the pain is severe, then the patient may refuse not only to eat, but also to drink, which can cause dehydration.
5. Nausea and vomiting, and they can be prolonged and cause dehydration. In some cases, vomiting is accompanied by the appearance of whitish films - these are dead colonies of fungi.
6. Pain can also appear in the upper abdomen.
7. Fever, sometimes chills.
8. Unreasonable diarrhea, while after some time blood may appear in the feces.
9. A sharp decrease in body weight.

In the event that fungi spread from the esophagus higher into the oral cavity, then other symptoms appear. So, on the gums, on the tongue, on the inside of the cheeks, that is, on the most vulnerable areas, a whitish coating or individual white spots form. Cracks may appear at the corners of the lips.

It is possible and necessary to treat esophageal candidiasis at any stage of the disease. It develops rather slowly: at first it affects only the outer mucous membranes, then it gradually progresses and begins to penetrate into the internal structures. And over time, a film of a characteristic type forms on the surface of the mucous membrane. Then they grow and can completely block the lumen of the esophagus. If you do not start treatment on time, then ulcers and phlegmon may first form on the walls of the esophagus, and then these areas may completely die. In this case, it is possible that a secondary infection has joined the candidiasis, the treatment of which requires the use of antibacterial drugs. And the sooner the patient deals with all this, the less harmful consequences will be.

Diagnosis of candidiasis

Whatever the clinical picture, candidiasis in the esophagus must first be diagnosed, and only then choose a treatment method. The doctor necessarily conducts an endoscopic examination and cultures the microflora. With candidiasis of this type, esophagitis occurs at the initial stage, i.e. inflammation of the mucous membrane of the esophagus, and it will be perfectly noticeable during endoscopy, as it is manifested by redness and swelling. In addition, contact with mucous membranes may cause bleeding where the endoscope has touched the surface. On the mucous membranes, a white coating also appears, resembling a cobweb.

Esophagitis can develop not only in catarrhal, but also in fibrinous form, and then it will be noticeable already in a different clinical picture: large white-yellow, sometimes with a grayish coating of plaques appear on the mucous membranes, which differ in their relief form - they even protrude above the surface. And the mucosa itself is so inflamed that it becomes a bright red color. This picture is typical for the second stage of intestinal candidiasis.

Finally, in the third stage, the doctor can diagnose fibrinous-erosive esophagitis using endoscopy. Plaque on the mucous membrane already takes the form of a fringe. Sometimes it is separated instrumentally, and then a bright red mucous membrane covered with ulcers becomes visible under it. Its surface becomes very vulnerable. At these stages, it is already difficult to carry out endoscopy, because the esophagus narrows due to edema, the patient's pain, including due to this procedure, intensifies.

When diagnosing, it is very important to conduct a microbiological study of mucus, which is taken directly from the esophagus. This analysis helps to understand which drugs the fungi that are the causative agents of the disease will be sensitive to.

Treatment of esophageal candidiasis

Although theoretically, approximately the same drugs are used to treat all types of candidiasis, in this case we are talking about a more dangerous form of the disease. Therefore, the treatment of esophageal candidiasis requires stronger drugs and at a higher dosage than for oral or vaginal candidiasis. Some caution must be exercised here. The fact is that such drugs often lead to an increase in liver enzymes in the blood, which does not improve well-being. In addition, they can enter into chemical reactions with other drugs. For example, this applies to antihistamines and sedatives. If the patient is forced to constantly take pills of this kind, then you should immediately tell the doctor about it so that he can adjust the treatment.

The most popular drug for candidiasis is fluconazole. Unfortunately, pathogenic microorganisms quickly develop resistance to this drug. The course of taking Fluconazole is 2-3 weeks.

Sometimes doctors replace it with the more effective Itraconazole. Unlike other drugs of this kind, it is not produced in tablets, but in liquid form. Often it is prescribed in combination with flucytosine, which increases its effectiveness.

Another drug, ketoconazole, may also be used. Usually in pharmacies it is easier to find it under its trade name - Nizoral. For this drug, the course of administration is designed for 3-4 weeks. But this medicine is incompatible with some antiretrovirals. The choice of a specific antifungal agent is usually made according to the results of an analysis that reflects the sensitivity of microorganisms to a particular active substance.

If candidiasis is already in the most severe third stage, then the doctor may prescribe antimycotic drugs not in the form of tablets, but in the form of intravenous injections so that they work faster.

Diet food

A diet for candidiasis should create favorable conditions for normal microflora and extremely unfavorable conditions for opportunistic pathogens. But at the same time, it must provide a person with a complete set of vitamins and minerals, because in order for the body to restore normal immunity, it needs all the nutrients.

Therefore, in esophageal candidiasis should be aimed at restoring the mucosa. That is, she will largely repeat the diets that are prescribed for gastritis. The forbidden foods on this diet include any bakery products based on yeast dough, since it only irritates the mucous membranes. This also applies to honey cakes. Fresh honey will have to be abandoned - it can cause an allergic reaction, this will lead to a decrease in immunity and aggravation of the manifestation of candidiasis. For the same reasons, chocolate and sweets based on it are excluded. Firstly, it irritates mucous membranes, and secondly, it can cause allergies. And in general, an excess of carbohydrates with candidiasis is not needed. Therefore, the amount of sugar in the diet will have to be reduced.

Under the ban are various marinades, sauces like ketchup and mayonnaise, vegetables canned with vinegar, pickles, mushrooms and other delicacies of this kind. Sausages, semi-finished meats and smoked meats, including smoked fish, should be excluded from the diet. In general, food should be such that it does not irritate the stomach and esophagus. Therefore, acidic fruits and vegetables should also be avoided. First of all, this applies to citrus fruits, but apples can also be harmful - pain will only intensify. You can eat meat and fish, but only dietary varieties.

With candidiasis of the esophagus, treatment is not just dieting, but also a special diet. Sick people need to eat smaller portions, but more often, up to 5-6 times a day. All food should undergo specific cooking, which is aimed at facilitating the swallowing of food as much as possible. Dishes are usually steamed, with a minimum amount of seasonings and spices (most of them irritate the mucous membrane). Despite the common misconception about the connection of candidiasis (thrush) with a high amount of dairy products in the diet, doctors recommend consuming them as much as possible, because they perform the functions of probiotics and accelerate the settlement of the body with normal healthy microflora.

It is difficult to get rid of this fungus, but it is quite possible. You just need to strictly follow the doctor's instructions, stick to a diet and do not violate the dosage of prescribed medications.

Fungal infection worries in most cases people with weakened immune systems. It manifests itself in the defeat of the skin, mucous membranes, nails, hair and even internal organs. In women, thrush of the genital organs is often diagnosed, and in infants - oral thrush. One common pathology is esophageal candidiasis, which is characterized by the growth of fungi in the food tube and gastrointestinal tract. The disease can proceed for a long time without pronounced symptoms, so it is problematic to diagnose it at home. Before treating esophageal candidiasis, you must consult a doctor and undergo the necessary examinations to identify the type of fungus.

What is esophageal candidiasis

A fungus is an infectious disease, the appearance of which is due to the activation in the human body of any type of fungus of the genus Candida. Almost all living beings have a small content of the fungus in the body, but under the influence of certain factors, its number increases, which leads to the disease.

The symptoms of candidiasis are often blurred, not all doctors can make a correct diagnosis. Even in advanced cases, the signs of the disease in adults are not always easy to notice, it is important to pay attention to well-being for a long time. Most patients who seek help complain about the following:

• severe pain immediately after eating in the stomach;
• an increase in body temperature to 37.5 degrees for a long time;
• nausea, sometimes reaching vomiting;
• constant heartburn and discomfort in the throat;
• constipation or diarrhea.

There may also be poor appetite due to abdominal pain. Many people suffer from fungus with severe pain and nausea that interfere with normal digestion. This results in dehydration and weakness. During swallowing, some feel discomfort and a sensation of a lump in the throat, in some cases, patients are not able to swallow even water without discomfort. In severe cases of the disease, curdled particles appear during vomiting or discharge along with saliva. In the feces, traces of blood or mucus are possible, which indicates violations in the work of the intestines.

Nausea

The danger of the disease is that it quickly passes from the esophagus to the stomach, and then into the intestines, causing other problems. During reproduction, fungal spores create many filaments on the mucous membranes that interfere with the passage of food.

Causes of the disease

Many people are carriers of candidiasis, but do not even realize it. After activation, candidiasis in the esophagus begins to affect the tissues, which leads to a deterioration in the condition. What causes the growth of microorganisms? There are many reasons that affect the course of the disease, among them:

• mechanical damage to the walls of the esophagus during diagnostic examinations (for example, FGDS) or solid food;
• reduced immunity against the background of a chronic disease, elderly or childhood, as well as pregnancy;
• acquired immunodeficiency syndrome or HIV infection;
• chemotherapy or radiation for malignant tumors;
• long-term use of medications without the supervision of a specialist;
• diseases of the endocrine system;
• hormonal disruptions.

In addition, an unbalanced diet, smoking, alcohol or drug addiction negatively affects health. The fungus is contagious, its spores can be transmitted from an infected person to a healthy person. In women and men, there is a fungus of the genital organs or thrush, the transmission of which occurs through household or sexual contact. There are many reasons for the appearance of the disease, but there is only one correct solution to the problem - diagnosis, treatment and further control.

Methods for detecting fungus

It is important to recognize the signs of esophageal candidiasis in time and seek qualified help. The disease can progress, affecting the oral or nasal cavities. If white spots or mucus are visible in the mouth, then this indicates the development of the fungus and requires immediate help. The neglected stage first causes the appearance of small ulcers on the walls of the stomach and esophagus, and then tissue death. In the affected areas, infections are often present, contributing to necrosis. In this case, the patient requires surgical intervention and a long recovery.

To make a diagnosis, you need to contact a gastroenterologist. He will prescribe a number of diagnostic procedures, for example, an endoscopic examination of the walls of the esophagus and stomach, mucus sampling for seeding on microflora and a biopsy. After receiving the test results, the doctor puts one of the forms of the disease:

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1. catarrhal esophagitis. During the examination, swelling of the walls is noted, when the esophageal mucosa is touched by the endoscope, slight bleeding appears. The specialist also notices the presence of a fungal cobweb and a light plaque.
2. fibrinous esophagitis. The walls of the esophagus are covered with a white or yellow coating, there are plaques of a darker shade. The mucous membranes are edematous and have a reddish color. When the equipment is exposed to the esophagus, bleeding occurs.
3. Fibrinous-erosive esophagitis. A dark gray coating is visible on the walls, under it are inflamed mucous membranes with ulcers up to 4-5 mm. During the advancement of the endoscope, the patient feels severe pain, as the passage becomes narrower due to swelling and the camera cannot be penetrated without tissue damage.

Examination by a gastroenterologist

Diagnosis of esophageal candidiasis can also occur in a different way. Sometimes it is possible to take mucus from the throat or nose, but if there is not enough data, then endoscopy is prescribed. The biological material obtained during the procedures is always sent for microbiological examination. In the laboratory, the type of fungus and its resistance to drugs are determined, only after that an effective therapeutic regimen can be prescribed.

Treatment of the disease

Without fail, the patient is prescribed antifungal drugs. They are: Fluconazole, Clotrimazole, Itraconazole, Miconazole. The active substances of these drugs are aimed at destroying the spores of the fungus and relieving the symptoms of the disease. It is possible to take other drugs based on nizoral or imidazole. Fluconazole for esophageal candidiasis is considered the most powerful. The destruction of pathogens by this medicine does not adversely affect health and is safe even for children older than 3-4 years. However, it should not be taken during pregnancy and individual intolerance. The duration of treatment, dosage depend on the severity of the condition and the characteristics of the human body. It is necessary to read the instructions for use before taking, study the contraindications, as well as how to take the remedy.

Fluconazole

Together with antimycotic tablets, enterosorbent therapy is prescribed to the patient. It is necessary to remove from the body all the harmful toxic substances left after the fungus. Examples of drugs are Atoxil, Enterosorb, Polysorb and Enterosgel. Without this, treatment can be delayed for a long time.

In general, treatment for candidiasis lasts at least 30 days. In addition to antifungal agents, vitamins, bifidobacteria or physiotherapy can be prescribed. The recipes of healers are useful for the disease, but you should not treat esophageal candidiasis with folk remedies without consulting a doctor. In traditional medicine, there are no other methods of treatment, except for the use of special drugs. Together with the main therapy, it is recommended to rinse your mouth with soda solution, calendula or chamomile. To normalize the work of the stomach, it is allowed to drink decoctions of chamomile, oak bark or St. John's wort. Reviews confirm the effectiveness of herbal remedies in conjunction with the prescribed therapy.

Diet for sickness

Nutrition for a fungal infection can stop the reproduction of spores or, conversely, speed it up. He needs to pay special attention and find out what you can eat with candidiasis and what you can’t. Diet speeds up the healing process, and is also a preventive measure to prevent relapses.

Nutrition for esophageal candidiasis has two basic rules. The first is the intake of only liquid, soft and puree foods. It is necessary to exclude any solid foods that can scratch an already diseased organ. It is necessary to prepare liquid cereals from rice, semolina or oatmeal, and grind soups with a blender. The second is the rejection of prohibited foods. From the diet it is necessary to cross out any dishes that adversely affect therapy. The list of prohibited foods includes:

• yeast products, including bread;
• fatty, spicy, salty and sour foods;
• mushrooms of any kind;
• smoked sausages and other similar products;
• seasonings and mustard;
• sweet soda, alcoholic drinks;
• chocolate, sugar;
• citrus;
• sour berries;
• strong tea and coffee.

If the fungus is running and the disease has already affected the entire gastrointestinal tract, then it is necessary to exclude additional products. These include potatoes, carrots, beets, lactose, honey, dried fruits, and anything sweet. A diet for gastric candidiasis excludes food that causes fermentation - kvass, beer, soda, sweet fruits. Such dishes are replaced with low-carb foods - lean fish and meat, steamed vegetables and baked fruits.

Do not be afraid - these products should be excluded only during the period of exacerbation. When the disease begins to recede, the usual food can be eaten in small quantities and monitor the body's reaction. The duration of the therapeutic diet is from 1 month. At first, such a diet may cause apathy, weakness and a decrease in concentration. This is due to a lack of carbohydrates, but this condition disappears within 7-10 days.

Disease prevention

It is possible to cure candidiasis, it responds well to treatment, but any kind of fungus can return after a while. Weakened immunity, prolonged use of antibiotics, and poor nutrition are what can cause candidiasis to come back. Preventive measures are recommended to prevent re-infection.

The first thing to do is to strengthen the immune system and health. This can be done with the help of vitamin complexes, immunomodulators and the right lifestyle. You should walk more, harden and play sports. A healthy body with a strong protective function is able to overcome many infections on its own. The second rule that must be followed is a diet for esophageal candidiasis. It is nutrition with a fungal infection of organs that pays great attention.

If several signs of the disease are detected, one should not neglect the appeal to the doctor. Early diagnosis of esophageal candidiasis prevents worsening of the condition and reduces treatment time. Therapy should be complex and carried out under the supervision of a specialist. To prevent the pathology from returning again, you must follow all the recommendations of the doctor and take care of your health.

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Content

Gastroenterological deviations from the normal functioning of a certain organ appear both as a result of endogenous factors and as a result of the negative impact of the environment. One of the reasons for the development of diseases of the gastrointestinal tract is candidiasis of the esophagus (thrush), which is caused by Candida fungi; diagnosing the disease is not so easy, since the pathology does not show symptoms for a long time, especially with impaired immunity.

What is esophageal candidiasis

Infection with a fungus of the digestive tract with the active action of pathogenic microorganisms Candida is called candidiasis in gastroenterology. According to the international classification of diseases, pathology belongs to the group of lesions of the esophagus and has the code K22.9. Visceral candidiasis has a long period of treatment, while the success of therapy depends on the accuracy of the diet and the regimen for taking the drugs prescribed by the doctor. The fungus of the esophagus often develops with a decrease in immunity, a violation of the use of antibiotics and the activation of HIV.

Symptoms

At the initial stage of candidal lesions of the gastrointestinal tract, signs of pathology practically do not appear. Three out of ten patients with a fungus have a sluggish clinical picture and a minimal severity of the disease. However, if you are attentive to the state of your health, you can notice the following symptoms, indicating a violation of the microflora of the esophagus, due to the activity of fungi:

• the presence of subfebrile temperature;
• discomfort in the diaphragm;
• difficulty swallowing;
• characteristic plaque in the oral cavity (optional symptom);
• frequent heartburn;
• chest pains;
• lack, loss of appetite;
• liquid feces, which may contain blood or mucous clots;
• frequent nausea, with vomiting, you can notice the presence of mucus in the masses.

Gradually, the amount of mucus on the walls of the esophagus increases, which creates difficulties in the passage of food through the lumen of the esophagus, which greatly complicates the course of the disease. The lack of therapy complicates the course of thrush, creating excellent conditions for the penetration of activated forms of the fungus into the walls of the stomach and intestines. However, in the absence of severe pathological processes in the gastrointestinal tract (ulcer-necrotic phenomena, surgical intervention), this is extremely rare.

Reasons for development

Normally, Candida fungi "live" in different organs of the gastrointestinal tract, without affecting human health. In the environment, they are found everywhere, so it is not difficult for them to penetrate the digestive and other systems. This usually happens under the following circumstances:

• in contact with household items used by an infected person;
• food contamination;
• by contact with people infected with fungi.

Factors that increase the risk of the disease

The optimal condition for uncontrolled reproduction of candida is a decrease in immunity. Many patients with esophageal thrush are children who have not fully developed the body's defense system, and people with HIV. In addition, there are a number of factors of exogenous and endogenous nature that increase the risk of pathology. These include:

• hyperemia;
• hyperparathyroidism, hypoparathyroidism;
• toxic reactions of the body;
• violation of the motor function of the esophagus;
• diabetes;
• hormonal disorders;
• frequent allergic reactions;
• antacid therapy;
• lack of protein in the body;
• nutrition of parenteral and enteral types;
• transplantation of tissues, organs;
• smoking, alcohol abuse;
• insufficient patency of the esophagus;
• acid-base imbalance of gastric juice;
• chronic infections (Koch's wand, etc.);
• prolonged antibiotic therapy;
• corticosteroid treatment.

Classification of inflammation

Candidiasis in the esophagus is divided into several varieties, depending on the severity of the damage to the mucous membrane of the fungus and the specifics of the manifestation of the pathology. So, there are three forms of the disease:

1. Erosive esophagitis of a fibrous type. With such a disease, stenosis of the esophagus develops, as a result of which the doctor hardly succeeds (or it is not at all possible) to advance the endoscope along the walls of the organ. The surface of the lesion is characterized by the presence of gray ribbons in shape resembling a fringe. The mucosa of the organ is edematous, has a reddish color over the entire surface.
2. pseudomembranous esophagitis. Such candidomycosis of the esophagus is accompanied by the formation of plaques on the walls of the mucosa. During endoscopic examination, ulcers and wounds appear on the organ.
3. catarrhal type of disease. Mucous swells, reddens. The affected areas of the organ look like a spider web

Complications of thrush of the esophagus

At the beginning of the development of pathology, plaque covers only the mucous membranes and causes local inflammation. As it develops, mycosis of the esophagus spreads to neighboring organs, causing swelling, burning, and pain. A characteristic film of a curdled structure closes the lumen of the esophagus, which stimulates vomiting. If the pathology is not diagnosed in a timely manner, this can lead to such complications:

• tissue necrosis will begin;
• there will be non-healing wounds;
• bleeding will open;
• there will be chronic inflammation of the esophagus.

Diagnostics

The definition of the disease begins with the collection of an anamnesis, in which the patient tells the doctor about the symptoms, changes in his condition recently. Esophagoscopy is the main diagnostic method for detecting candidiasis of the folds of the esophagus. The procedure helps to identify hyperemia of the affected areas of the organ, fibrous plaques, erosion of the mucous membrane, etc. The method involves the use of special optical tubes. Other diagnostic measures that a doctor can resort to are:

• x-ray examination with contrast (the images clearly show fibrous formations of various shapes and sizes);
• CPR diagnostics, seeding (helps to establish the DNA of a pathogenic microorganism);
• biopsy (a sample of the mucosa is taken by introducing special tools through the nasal passage).

Treatment of esophageal candidiasis

Therapy of the disease is carried out with the help of antifungal drugs and immunostimulants. A remedy for a fungus is prescribed only after the type of pathogen has been established in the course of laboratory tests. The doctor prescribes immunostimulating drugs if a violation of the functioning of the immune system has been detected. Different types of such agents have a different degree of impact on the functional units of human immunity, which is also taken into account by a specialist.

If a fungus of the esophagus is found in a person, it is imperative to check for the presence of systemic candidiasis in other organs of the gastrointestinal tract. If the infection has spread to the stomach and / or intestines, the doctor prescribes complex therapy for thrush. For this purpose, a special diet and oral or intravenous use of antimycotic drugs are used. The following methods can be used to increase the chance of a cure for candidiasis:

• operational diagnosis;
• antifungal therapy with effective medications;
• the use of therapeutic measures to activate phagocytosis and increase the number of granulocytes.

Medicines

Before treating candidiasis, the patient must undergo a comprehensive examination. With the help of diagnostics, you can confirm or refute the diagnosis. Depending on the results of the examination, a treatment regimen is prescribed. As a rule, it includes such drugs:

1. Enterosgel. The enterosorbent has the form of a paste that has no taste or smell. The drug helps to cleanse the body of allergens, pathogenic bacteria, toxins and toxins. The advantage of the drug lies in the minimum list of side effects that appear only in isolated cases. The disadvantage of Enterosgel is the high cost.
2. Anaferon. The immunomodulator is used in the complex treatment of viral bronchitis, acute respiratory infections, pneumonia, acute respiratory viral infections, herpes, and various immunodeficiency states. The big pluses of the medicine are its homeopathic origin and bright antiviral effect. Disadvantages of Anaferon, according to reviews, have not been identified.
3. Immunal. This tool has an antiviral, anti-inflammatory, immunostimulating effect. The key component of the drug is echinacea. Immunal is used to strengthen the immune system in various diseases, including candidiasis. The advantage of the drug is its versatility in the treatment of various pathologies, in addition, even small children can be treated with it. The disadvantage of the drug is the relative high cost, the ban on the use of people with AIDS and autoimmune diseases.

Antifungal drugs

Patients with moderate severity of fungal infection of the esophagus and minor disorders of the immune system are shown a short course of therapeutic drugs. As a rule, antimycotic treatment takes place in this case using an absorbable group of agents in the form of oral azole. Treat esophageal candidiasis, as a rule, begin with one of these drugs:

1. Clotrimazole. This drug belongs to a broad-spectrum antifungal agent and is available in the form of anal, vaginal suppositories, solution, etc. The drug disrupts the vital activity of pathogenic fungi that provoke an inflammatory process in the esophagus. The disadvantage of the drug is a ban on its use in children under 12 years of age, as well as in the presence of indigestion. The big pluses of Clotrimazole are efficiency and speed of action.
2. Ketoconazole. It begins to act after the first dose and gives an excellent effect in the treatment of damage to the esophagus. The active substance is perfectly absorbed in the gastrointestinal tract in the presence of an optimal acidic environment. The disadvantage of the drug is its ineffectiveness in acid-base imbalance. The advantage of Ketoconazole is considered to be fast action.
3. Fluconazole. It is a water-soluble form of Triazole. Like Ketoconazole, Fluconazole will only be effective if the acidity of the stomach is normal. The most effective drug for the treatment of candidiasis of the esophagus than other organs of the gastrointestinal tract. Minus Fluconazole in the presence of many side effects. The advantage of the drug is the speed of action and lasting effect.

Diet

Candidiasis develops rapidly in an environment containing glucose and yeast, so the doctor strongly recommends that a patient with such a diagnosis refuse food that provokes further reproduction of fungi. So, a diet for esophageal candidiasis implies a rejection of:

• any sweets, sugar;
• yeast baking;
• alcohol;
• kvass;
• whole milk (lactose is one of the favorite treats of the fungus).

Any malnutrition can lead to a relapse of the disease, so the diet should be followed with all rigor. In the diet of the patient must be present such healthy foods rich in fiber:

• natural dairy products, including cottage cheese, kefir, yogurt;
• greens;
• buckwheat;
• legumes;
• berries;
• fresh vegetables, fruits.

Folk methods

Doctors welcome the use of alternative medicine only as additional measures of therapy, the main treatment of the disease is the use of antimycotics and immunostimulants. You can treat candidiasis with proven folk remedies - herbal decoctions and tinctures. The most effective methods include:

1. Herbal decoction. Mix equal amounts of oak bark, chamomile flowers and calendula. Boil a tablespoon of the mixture in a water bath for 15 minutes, then cool and drain. Take the remedy daily for 1 glass, breaking the intake into several times.
2. Soda rinses. An additional effect can be achieved if rinsing the oropharynx with a soda solution 2-3 times a day. For its preparation 1 tsp. powder is diluted in a glass of barely warm water.
3. Tea mushroom tincture. This remedy is effective not only for candidiasis, but also for tumors of the esophagus. Place the mushroom in a jar, pour sweetened tea (10 g of tea leaves and 80 g of sugar per 1 liter of water). Leave the container in the dark for a week. Take the finished product 200 ml daily for 4 doses.