Not many patients know that thrush (candidiasis) can occur not only on the skin, but also on the gastrointestinal mucosa. Often there is fungal inflammation of the esophagus. The disease is accompanied by severe heartburn and other unpleasant symptoms. What is the treatment for esophageal candidiasis? After all, you can not get rid of it with the help of ointments and creams, like a fungus on the skin. The methods of treatment of this disease we will consider in the article.
Causes
The causative agent of esophageal candidiasis is Candida. Normally, this microorganism is present in the digestive tract in many people, and this does not lead to disease. However, if the fungus begins to multiply excessively, then inflammation occurs - candidiasis. Such a pathology can affect various organs, including the esophagus.
The fungus can be transmitted by contact and use of the same dishes with a sick person, as well as the use of infected products. Most people are carriers of this microorganism, but only those who have an active form of the pathology are dangerous.
There are cases of self-infection. If the patient already suffers from candidiasis of the mouth or stomach, then the infection can pass to the esophagus.
What contributes to the active growth of fungus in the body? The following factors can provoke the disease:
- trauma to the walls of the esophagus (when passing solid food and sharp bones, as well as during a medical examination);
- poor nutrition;
- protein deficiency in the body;
- prolonged use of corticosteroids and antibiotics;
- endocrine disorders (diabetes, adrenal hypofunction);
- pregnancy;
- past colds;
- HIV infection;
- exacerbation of chronic pathologies.
Symptoms
In approximately 30% of cases, the disease is asymptomatic. The patient may not even suspect that he is sick with a fungal infection. Pathology is detected by chance during a medical examination.
Most patients have inflammation - esophagitis. The following symptoms of esophageal candidiasis are noted:
- discomfort and pain in the sternum;
- severe heartburn;
- belching with a sour taste;
- temperature increase (up to +37.5 degrees);
- difficulty and pain when swallowing;
- nausea and vomiting;
- diarrhea;
- loss of appetite.
Such manifestations of the pathology are non-specific, they are found in many other diseases of the gastrointestinal tract. To establish the fungal etiology of the disease is possible only with the help of diagnostic studies.
Complications
At the beginning of the disease, only inflammation of the mucous membrane of the esophagus is noted. But then the fungus sprouts threads in the structure of the tissues and causes a deeper damage to the organ. Ulcers form on the mucosa. A neglected form of the disease can result in severe complications:
- stricture (narrowing of the lumen) of the esophagus;
- bleeding from sores;
- perforation of the esophagus;
- the spread of infection to the oral cavity, intestines and stomach;
- sepsis.
It is important to remember that the danger of such consequences increases every day. After all, the condition of the mucous membrane of the esophagus is rapidly deteriorating.
Diagnostics
Most often, patients turn to the doctor complaining that they were tormented by heartburn. What to do in this case? A burning sensation in the esophagus is observed with various forms of esophagitis. It is necessary to undergo a diagnosis and identify that the inflammation is caused precisely by the fungus. Establishing the cause of inflammation will determine all further tactics for the treatment of candidiasis of the esophagus.
The patient must undergo esophagoscopy. In this study, a special tube is inserted into the esophagus, at the end of which an optical device is fixed. On examination, the doctor may notice inflammation of the esophagus, as well as white plaque on the walls of the organ. This indicates the fungal origin of the disease.
The mucus remaining on the esophagus tube is sent to the laboratory for bacterial sowing. This allows you to determine the type of pathogen. Esophagoscopy sometimes takes tissue particles for microscopic examination.
Treatment principles
Patients should tune in to long-term treatment of esophageal candidiasis. It is impossible to get rid of such a disease in a few days. The treatment process usually takes at least 1 month.
Taking medications must be combined with a diet. If the patient takes medication, but does not follow the rules of nutrition, then the therapy will be ineffective.
Doctors prescribe the following groups of drugs for candidiasis of the esophagus:
- antimycotic (antifungal) agents;
- enterosorbents;
- proton pump inhibitors.
Next, we will consider in more detail these types of drugs.
Antifungal drugs
To get rid of the infection, it is necessary to take drugs that affect the pathogen. If fungus on the skin and nails can be controlled with ointments and solutions, then candidiasis in the digestive tract can not be cured by local means. Irrigation of the esophagus with disinfectant solutions will not give any effect.
In this case, oral antifungal medication is required. There are several groups of antimycotic agents:
- Azoles. These are drugs based on fluconazole, ketoconazole and itraconazole. They are most effective in treating fungal infections in the digestive tract. Such drugs penetrate the membrane of the fungus and disrupt the synthesis of vital substances. This leads to the death of the pathogen.
- Polyenes. This group of drugs includes Amphotericin B. These funds violate the integrity of the cell membrane and dissolve the fungus.
- Candines. This is a new group of antimycotic drugs. They block the formation of components of the cell walls of the fungus. These medicines include: Caspofungin, Micafungin, and Anidulafungin.
Let us dwell in detail on preparations from the azole group. They are most often used to treat fungal infections in the digestive tract. Therapy usually begins with drugs based on ketoconazole. They may have different trade names:
- "Nizoral";
- Mycosoral;
- Ketoconazole.
The price of Nizoral tablets is about 750 rubles. This is a rather expensive medicine. Therefore, patients are often interested in cheaper counterparts. The price of Mikozoral is slightly lower - about 460 rubles.
The most economical option is Ketoconazole. Its cost is almost 10 times less than the price of Nizoral tablets and is about 80 rubles.
Which of the above drugs is better? This question is difficult to answer unambiguously. All these drugs have the same active ingredient - ketoconazole and have a similar effect on the causative agent of the disease. The difference in the price of these drugs is due only to the fact that the drugs are produced by different manufacturers.
Currently, fungal strains are gradually developing resistance to ketoconazole. Therefore, with the ineffectiveness of therapy, drugs based on fluconazole ("Flucostat", "Forkan", "Diflucan") or based on itraconazole ("Orungal") are used.
If azole preparations do not help, then they are replaced by Amphotericin B or Candine.
Enterosorbents
Along with antifungal treatment, enterosorbent therapy of candidiasis is performed. What it is? The treatment method is to take drugs that absorb toxins. The pathogenic fungus secretes the products of its vital activity into the digestive tract. The following drugs will help to remove harmful substances:
- Atoxil;
- Enterosorb;
- Polysorb;
- Enterosgel.
Instructions for use of Atoxil in bags reports that this drug not only removes toxins, but also has bactericidal and wound healing properties. This is especially important for candidiasis, when the mucous membrane of the esophagus is badly damaged by the threads of the fungus. Therefore, doctors recommend using this particular new generation enterosorbent.
Proton pump inhibitors
Very often, patients complain that they were tormented by heartburn. What to do? How to reduce discomfort? Burning in the esophagus with candidiasis can be so strong that it often deprives the patient of sleep.
Conventional antacids ("Almagel", "Maalox") relieve heartburn well in diseases of the stomach, but are not always effective in fungal esophagitis. Doctors recommend taking Omeprazole (Omez) for candidiasis. It belongs to the proton pump inhibitors - a new generation of drugs that normalize acidity. It acts more gently than traditional antacids, and quickly eliminates unpleasant sensations.
New Therapies
Experts have proven the effectiveness of autohemotherapy in the treatment of candidiasis. What it is? With this method of treatment, a small portion of the blood is taken from the patient, irradiated with ultraviolet light and injected back. This helps activate immunity to fight infection.
Autohemotherapy is usually combined with another new treatment method - endoscopic granulocyte mass administration. Donor blood cells - granulocytes - are delivered to the esophagus through a special tube. To activate immunity, several such procedures are necessary. Immunomodulating therapy allows for faster healing.
Diet
A diet for candidiasis of the esophagus and stomach is an integral part of treatment. From the diet, it is necessary first of all to exclude sweets, chocolate, honey, soda, yeast baking. It is important to remember that a sweet environment is favorable for the growth of the fungus.
It is also necessary not to eat spicy foods in order to avoid irritation of the inflamed mucosa of the esophagus. Indigestible foods are also prohibited: mushrooms, barley, strong meat soups, canned food, fatty and fried foods. Such foods can increase heartburn. Coffee and alcohol are strictly prohibited.
With esophageal candidiasis, fermented milk products are very useful. The beneficial lactobacilli contained in them are the natural enemies of the fungus. Kefir, whey, tan and bio-yogurt can be consumed in any quantities. The types of fermented milk products must be periodically changed so that the fungus does not have time to adapt to them.
In the diet you need to include pickled vegetables, seaweed, fish, this will help to recover more quickly. With pain, it is useful to use a drink from Kombucha, as well as mucous rice and oat decoctions.
Folk remedies
Is it possible to treat esophageal candidiasis with folk recipes? It is impossible to completely get rid of the infection without the use of antifungal drugs. However, folk remedies can supplement drug treatment.
With candidiasis, it is useful to rinse with soda. This will help prevent the spread of infection from the esophagus to the oral cavity.
Inside, you can take a decoction of chamomile or tincture of propolis. These funds are not able to destroy the fungus, but they have anti-inflammatory properties and reduce discomfort in the esophagus.
It is useful to take pharmacies based on echinacea. This is a wonderful natural immunomodulator that will help the body fight the fungus.
Forecast and Prevention
Esophageal candidiasis has a favorable prognosis. The disease is successfully cured by modern antifungal agents. Repeated cases of fungal infection in the esophagus are rare, but relapse of candidiasis in another area of the body is not ruled out.
Prevention of esophageal candidiasis is to comply with the following recommendations:
- Avoid contact with people with exacerbation of fungal infection.
- With a tendency to candidiasis, eat less sweet and yeast food, as well as varieties of blue cheese.
- Antibiotics and corticosteroids should only be taken under medical supervision.
- Eat well, make sure that the food contains enough protein.
- Be careful when eating, so as not to accidentally injure the mucous membrane of the esophagus.
- Timely cure thrush in the oral cavity.
These measures will help to avoid an unpleasant disease that requires a long and difficult treatment.