Candida And Gut Inflammation

Before we start, other blogs that you might be interested in, include:

• What to eat when you have mould illness
• Inflammatory Bowel Disease; The Why, Why, And How
• What Is The Gut-Brain Axis?
• Can gut health effect mental health?

Introducing Candida And Gut Inflammation

Candida organisms commonly colonise the human gastrointestinal tract as a component of the resident microbiota. Their presence is generally benign. Recent studies, however, show that high level Candida colonisation is associated with several diseases of the gastrointestinal tract.

Further, results from animal models argue that, in regards to candida and gut inflammation, candida colonisation delays healing of inflammatory lesions and that inflammation promotes colonisation (1).

These effects may create a vicious cycle in which low-level inflammation promotes fungal colonisation and fungal colonisation promotes further inflammation (1).

Candida Escapes The Gut

In a recent study that supports this view, researchers recovered Candida organisms from the blood of patients with candidiasis and compared those organisms to organisms cultured from the rectum or skin of the same patient. In most cases of C. albicans candidemia, the strain identified in a patient’s blood sample and the strain identified in the same patient’s rectum sample were identical.

These findings support the model that commensal organisms residing in the GI tract can escape from this niche and reach the bloodstream.

Candida Favours Certain Conditions

In the GI tract, C. albicans encounters and responds to varying features of the physical environment such as pH, oxygen levels and nutrient levels. C. albicans also responds to secretions produced in the GI tract such as bile. These findings argue that C. albicans is well adapted for growth in the GI tract.

Analyses of factors that regulate C. albicans colonisation show that the host immune system, bacterial competitors, and fungal gene expression impact GI tract colonisation by the organism. Colonization levels thus reflect an interplay between host activities, bacterial activities and fungal activities.

Candida Colonises In Gut Inflammation

Candida colonisation in patients suffering from GI tract disease has been documented in several situations. These include:

• Crohn’s disease.
• Ulcerative colitis.
• Gastic ulcers.

Thus candida and gut inflammation are certainly correlated.

Crohn’s disease And Candida

The inflammation that is characteristic of Crohn’s disease (CD), a type of inflammatory bowel disease (IBD), is thought to arise as a result of dysregulated immune interactions between the host and components of the intestinal microbial flora (1).

To test for an association between Candida colonisation and CD, a large-scale study of families in which multiple members suffered from CD was conducted. The authors studied both CD patients and their unaffected, healthy relatives. Healthy relatives often exhibit characteristics that have been noted in patients such as increased intestinal permeability or defects in oral tolerance, but they do not have clinical disease. Healthy relatives are therefore less likely to have been treated with medications that might increase the likelihood of Candida colonisation, such as antibiotics and immunomodulators.

Stool samples from both patients and healthy relatives more frequently contained significant levels of C. albicans than stool samples from control individuals, individuals who lived in the same geographic region and had no history of IBD. In addition to increased frequency of colonisation, patients and healthy relatives carried C. albicans at higher levels than control individuals.

A similarity in colonization between patients and HR was observed when family members lived together in the same household and when they did not. Therefore, similarity in carriage within families was not simply due to a shared environment. The authors suggest that subclinical inflammation is present in healthy relatives; this effect could influence C. albicans colonisation.

This study demonstrated an association between familial Crohn’s disease and intestinal colonisation by Candida albicans.

Ulcerative colitis And Candida

Patients with ulcerative colitis (UC), another form of IBD, are also frequently colonised by Candida. For example, in one study:

many patients with long standing disease (duration >5 yr) had high level colonisation detected in stool or brush smears from inflamed mucosa.

Among the control group, individuals with diarrhea but not UC, only one person was highly colonised (1).

Further, in patients with active disease who were colonised with Candida, treatment with the anti-fungal drug fluconazole led to a reduction in clinical signs and in the size of inflammatory lesions. Although these effects may be direct or indirect, the results argue that reducing Candida colonisation reduced disease severity.

Gastric Ulcers And Candida

Candida organisms colonise ulcers, particularly when the ulcers are large or perforated. In several studies, Candida organisms were cultured from gastric biopsies, brush samples of mucosa or peritoneal fluid.

Colonisation was observed more frequently in older patients and in patients with hypoacidity (1).

Candida Inhibits Healing Of Gut Inflammation

To elucidate the interplay between Candida and the host during disease, animal models of GI tract disease have been employed. Taken together, these studies show that Candida albicans exacerbates damage and delays healing of inflammatory lesions in animal models (1).

Inflammation Promotes Candida

Candida does not appear to evoke sufficient levels of inflammation to colonise the mouse GI tract successfully without antibiotic treatment.

However, the organism is able to exploit inflammation stimulated through other mechanisms to enhance its ability to colonise.

Since inflammation increases the likelihood of significant Candida colonisation and Candida colonisation reduces healing of lesions, these effects would produce a vicious cycle (1).