In gastroenterology, deviations from the normal activity of a particular organ occur as a result of endogenous causes, and due to environmental factors, one of which is microscopic parasitic fungi.
What is esophageal candidiasis?
Infection of the esophageal tube with the active action of the fungus of the genus Candida, from where the origin of the diagnosis is taken, is called candidiasis. According to the International Classification of Diseases of the 10th edition, pathology refers to the disease of the esophagus, unspecified.
Code of the disease by international classifier - K22.9.
Photo of esophageal candidiasis
The disease has a long duration of treatment, with insufficient compliance with diet, daily regimen and treatment regimen, the success of recovery is in question. Patients suffering from pathologies of the digestive system, in an amount of 1.5% of the total number of cases, find the candidiasis of the digestive system.
The appearance of the disease is facilitated by the failure of immune reactions, the activation of the human immunodeficiency virus, the disrupted reception of antibacterial agents.
Causes and factors of occurrence of
Candida fungi are found in various organs of the gastrointestinal tract in a passive state in a healthy person.
Esophageal candidiasis develops if activated infectious agents penetrate the cavity of the tube from the oral cavity( downward flow) or from the gastrointestinal region( ascending current).
In the environment, fungi of the genus Candida are often found, therefore, it is not difficult for them to spread into the human body. This occurs often under the following circumstances:
- seeding used food;
- various contacts of people, one of which is infected with fungi;
- contact with household items and household items that were in use by an infected person.
Only the walls of the esophagus are rarely affected by fungal infection, in most cases esophageal candidiasis is part of the overall clinical picture with lesions of several organs of the gastrointestinal tract.
The main optimal condition for the activation of the fungus of the genus Candida is the reduction of immune responses of the body. Most patients with diagnosed candidiasis of the esophagus are children with incomplete formation of immunity and people of adulthood with immunodeficiency.
A number of endogenous and exogenous factors increase the risk of esophageal pathology with activation of 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;
- alcohol abuse and smoking;
- diabetes mellitus of all types;
- increase of acid-base balance of gastric juice;
- insufficient esophageal patency;
- organ and tissue transplant;
- nutrition of enteral and parenteral types;
- abnormalities in esophageal motor reaction;
- corticosteroid injection or use of solutions with corticosteroids in inhalers;
- chronic infection( Koch's stick);
- protein deficiency in the body;
- long-term use of antibacterial drugs;
- antacid therapy.
Histological examination of the esophagus shows the content in the samples of affected tissues of hyphae of mycelium. Similar to the histological state of the esophagus is preceded by a weakened immune system.
Symptoms of esophageal candidiasis
The initial stage of esophageal candidiasis development is not accompanied by clinical signs and pathological sensations of patients. Surface penetration into the esophagus tissues, 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 diaphragm area;
- subfebrile temperature;
- deviations in the normal swallowing act;
- heartburn of varying degrees of sensation;
- retrosternal pain;
- liquid feces with splotches of blood clots and mucous fragments;
- decreased or absent appetite;
- painful sensations when trying to swallow, leading to depletion of the body or dehydration, which is characteristic of the severe degree of the disease when it becomes impossible to swallow the water;
- frequent nausea, vomiting presence of mucus is noticeable.
The increased formation of mucus and its accumulation on the walls of the esophagus creates additional difficulties with the permeability of food through the hollow tube.
The highest symptomatic manifestation of esophageal candidiasis is the following:
- esophageal stenosis;
- ulcer-necrotic processes with perforation of walls or without perforation;
- damage the blood vessels supplying the esophagus muscles.
In endoscopic examination of the esophagus, its walls in the initial stages look with a changed color range to a yellowish or whitish color, with convex sections. Later, colonies of Candida multiplied fungi are added to the affected foci, subsequently penetrating into the submucosa.
Laboratory studies of microflora of affected areas show the presence in tissues of not only fungi of the genus Candida but also pathogenic bacteria.
Recognition of the disease begins with an anamnesis of the data, where the patient describes complaints about the disease that have occurred recently. The main instrumental method for detecting esophageal candidiasis is esophagoscopy.
Endoscopic studies show hyperemia of affected areas of the esophagus, fibrous attack, rapid vulnerability in contact with instruments.
When the disease manifests three forms of candidiasis of the esophagus:
- Pseudomembranous esophagitis, in which the affected surface of the esophagus mucosa is accompanied by the formation of plaques. Attempts to penetrate the instruments along the esophageal wall lead to the appearance of wounds.
- Erosive esophagitis of fibrinous type. The endoscope is sometimes impossible to move along the walls of the esophagus because of its stenosis. The surface of the lesion differs from the esophagitis of type 1 by the presence of gray ribbons of fringe type. Mucous edematous, hyperemic throughout the surface.
- Catarrhal endophagitis. Mucous with this form of the disease is slightly reddened, edematous. Affected areas look like a spider web.
If it is not possible to insert a catheter through a mouth opening, its penetration is attempted through the nasal cavity. An endoscope is inserted inside the catheter. After the catheter is removed from the endoscope, the liquid left on it is subjected to a laboratory microscopic analysis.
When a mycelium is found in a biopsy specimen, fungi are planted and the main groups of drugs used in the therapy of esophageal candidiasis are treated. The drug that detected a low Candida resistance is assigned for later use.
In medicamental treatment stand 2 directions:
- Therapeutic treatment with antifungal agents( Fluconazole, Oranazole, Nizoral, Miconazole, Clotrimazole).Each of these drugs has specific uses: pregnancy, children under 4 years old, liver failure, high testosterone maintenance, etc.
- Enterosorbent therapy to facilitate the release of toxic products( Atoxil, Polyphep, Enterosorb, Polysorb, Antralen, Enterosgel).
As an external use, rinse the oral cavity after eating a solution of baking soda. Oral methods of applying phytopreparations( St. John's wort, Calendula vulgaris, chamomile, oak bark).
To increase the balance of microorganisms in the gastrointestinal tract, foods rich in useful prokaryotes: lactic acid foods, vegetables, pre-fermented, and mushroom are used in dietary nutrition.
Fresh cabbage, rosehips, rice, onions and garlic are often found in fresh foods or their decoctions in the daytime diet.
Prognosis and prophylaxis
Candidiasis of the esophagus is treatable by combining several methods of healing and observing a long-term treatment regimen.
Preventive measures for the prevention of esophageal candidiasis are divided into 2 directions:
- Common restorative measures to enhance immunity.
- Special prevention, including mainly dietary food.