It is an infectious lesion of the digestive tract, which is caused by the patient’s own fungal flora (Candidaspp.)
Against the background of a severe weakening of the immune system.
Experts identify two pathogenetic forms of intestinal candidiasis – invasive and non-invasive. Non-invasive intestinal candidiasis is a more common pathology, this type of disease occurs against the background of dysbiosis and mixed intestinal infection (fungal-bacterial, fungal-protozoal). In this case, fungi of the genus Candida begin to multiply rapidly in the intestinal lumen, without penetrating into the mucous membrane. At the same time, they release specific fungal toxins that form toxic products along with enzymes that are irritating to the intestinal mucosa. Toxic substances aggravate the course of dysbiosis, contribute to the development of mycotic allergy and secondary immunodeficiency.
The pathogenesis of invasive intestinal candidiasis is somewhat different. Provided that local and general immunity is weakened, Candida fungi attach themselves to the intestinal epithelium, after which they penetrate into its thickness, transforming into a filamentous form. In the presence of pronounced suppression of cellular immunity, Candida enters the bloodstream and spreads throughout the body, which provokes the development of visceral candidiasis, accompanied by damage to the liver and pancreas. The visceral form of pathology develops against the background of severe neutropenia.
There are three main forms of intestinal candidiasis – an invasive diffuse, invasive focal and non-invasive. When the patient has invasive diffuse intestinal candidiasis, a serious condition is detected that occurs on the background of severe intoxication, hyperthermia of the body and is accompanied by intense abdominal pain, diarrhea with blood in the feces. Sometimes systemic lesions of other internal organs can be detected. In most cases, intestinal candidiasis is detected by chance during examination for other diseases. Invasive diffuse intestinal candidiasis almost never develops in individuals with a normally functioning immune system.
Invasive focal candidiasis of the intestine in most cases is complicated by duodenal ulcer or ulcerative colitis. Suppose a person with this type of candidiasis allows the presence of persistent and protracted course of the underlying disease, which is not amenable to standard treatment. In this form of mycosis, local invasion of the filamentous Candida form in places of impaired epithelization is characteristic. At the same time in the nearby tissues, other parts of the intestine, the drusen of the fungi may not be detected. Clinical symptoms correspond to the underlying disease, with the pseudo-mycelium being detected by chance during histological examination of the biopsy.
Non-invasive intestinal candidiasis is the most common form of this pathology. When the disease is not observed penetration of fungi into the intestinal wall, in this case Candida actively reproduces in the lumen of the intestine. At the same time, a significant amount of toxic metabolites is released, which have not only local, but also general resorptive effects.
Diagnosis of pathology is complicated by the lack of characteristic clinical symptoms. A microscopic examination of feces and tissue samples is assigned to the patient to make a diagnosis, and a general and biochemical blood test and endoscopic examination of the intestine may also be required. All persons with a fungal infection of the intestine must be prescribed a feces test for dysbacteriosis.
The choice of therapeutic tactics depends on the clinical variant, the presence of comorbidities and the tolerability of antimycotic drugs. In addition, all patients undergo correction of background pathology, which has become the cause of reduced immunity.
Prevention of intestinal candidiasis is based on the timely treatment of background pathologies that predispose to the development of intestinal candidiasis and dysbiosis.