Candida is a genus of yeast that naturally resides in areas of the human body, including the gastrointestinal (GI) tract, where it generally coexists harmlessly with other microorganisms. An overgrowth of Candida, however, can lead to infections and various health issues, particularly affecting the GI tract.Β
This article explores the different types of Candida, their impact on various parts of the body, the visual signs indicating their presence in stool, and practical lifestyle changes to mitigate Candida overgrowth.Β
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What Is Candida?
Candida is a fungus usually present in small amounts on the skin, mouth, and vagina. Candida overgrowth occurs when the fungus overpopulates beyond what is considered commensal.Β
There are several different forms of Candida species, with Candida albicans being the most common. Other Candida species known to cause infection are Candida glabrata, Candida tropicalis, and Candida parapsilosis, although these infections are less common.Β
Normal Flora vs. Infection
In healthy individuals, Candida overgrowth is contained by a healthy immune system and adequate gut and vaginal flora. Candida overgrowth, also known as candidiasis, may be caused by:
- A diet high in processed food and refined sugars
- Lifestyle factors such as chronic stress, poor sleep, and lack of exercise
- Weakened immune system from autoimmune disorders, steroid use, HIV, or environmental toxins
- Antibiotic use, which disrupts healthy gut and vaginal flora
- Gut & vaginal dysbiosis, which causes changes in local pH, favoring candida overgrowth
Common Candida-Related Conditions
Candida infections can result in the following areas:
- Oral cavity (Thrush): Oral Candida presents as white patches on the tongue, throat, and other mouth regions. Patients typically present with soreness and difficulty swallowing.Β
- Vagina (Vulvovaginal Candidiasis): Vaginal Candida is one of the leading causes of vaginitis. It presents with genital itching, burning, and a white "cottage cheese-like" discharge from the vagina. The penis can also be affected. However, this is rare when compared to vaginal Candida.Β
- Skin (Cutaneous Candidiasis): Skin infections caused by Candida present with a red and itchy rash in moist body areas, such as the armpits, groin, or under the breasts.
- Gastrointestinal Candidiasis: An overgrowth of Candida in the gut is known as small intestinal fungal overgrowth (SIFO)βpatients with SIFO present with belching, bloating, gas, nausea, diarrhea, and indigestion.Β
Symptoms of Candida Overgrowth
Signs and symptoms of Candida depend mainly on where the infection is in the body. The following are the most common symptoms throughout the body caused by candida overgrowth:
- Itching
- Burning
- Joint pain
- Chronic fatigue
- White patches in the mouth
- Vaginal discharge
Symptoms Related to Candida in Stool
Gastrointestinal candidiasis has been associated with several diseases, such as Crohn's disease, ulcerative colitis, and gastric ulcers. When fungal species overgrow in the gut, it can disrupt normal digestion, leading to undesired symptoms:
- Diarrhea
- Abdominal pain
- Bloating
- Belching
- Gas
- Indigestion
What Does Candida Look Like in Stool?
Physical Appearance of Candida in Stool
Colonization of the gastrointestinal tract by fungal pathogens such as Candida albicans results in low-level inflammation in the gut. The inflammation caused by Candida is associated with various gastrointestinal diseases such as Crohn's, ulcerative colitis, and gastric ulcers.Β
The inflammation can result in mucus and biofilm production. Biofilms are used as a protective defense for organisms such as Candida. When passed in the stool, Candida has a white, clumpy, or stringy presentation. Candida may also appear as a yellow or brown mucus with froth or foam.Β
When to Consult a Doctor
A small amount of mucus in the stool may be normal. However, a typical bowel movement should not produce much mucus. You should contact your doctor if you notice increased amounts of mucus, blood, or pus or sudden changes in stool frequency, consistency, or color.Β
Fungal overgrowth in the gut can present similarly to other infections, such as bacterial or parasitic overgrowth. Laboratory testing is required to differentiate between the conditions.Β
Lab Tests for Candida
Stool Analysis
A stool test is a diagnostic tool healthcare practitioners use to identify bacteria, viruses, fungi, or parasites that may be causing gastrointestinal symptoms. A comprehensive stool test will help identify candida overgrowth in the gut and investigate potential imbalances in gut flora leading to overgrowth.
Blood Tests
A blood test can measure antibodies such as IgA, IgG, and IgM produced by the immune system against Candida albicans. This blood test does not indicate where the Candida overgrowth is; however, it helps quantify the severity of infection.Β
A candida antibody test is indicated for patients with more severe symptoms such as oral thrush, recurring vaginal and urinary tract infections, skin issues like eczema or psoriasis, joint pain, and brain fog.
Additional Tests
Further evaluation of Candida overgrowth may be needed in chronic and recurring infections. The following tests are recommended:
- SIBO Breath Test: A SIBO test is used to identify the overgrowth of pathogenic bacteria in the gut. Because SIBO & SIFO present with similar symptoms, it is critical to rule out the possibility of bacterial overgrowth in the gut.Β
- CBC: A complete blood count is a standard test to evaluate the immune system's health. For patients with recurrent candida overgrowth, it is crucial to assess white blood cells, which help fight infection and rule out other blood disorders.Β
- Vaginal Microbiome Assessment: For women with recurrent vaginal candidiasis, a vaginal culture can assess infection and possible dysbiosis. PCR Candida testing of vaginal specimens is also available and highly sensitive in the diagnosis of vaginal Candida.Β
Root Cause Treatments for Candida
Dietary Changes
Diet modification can play an important role in patients with intestinal Candida overgrowth. The "Candida Diet" has been developed as a potential avenue to limit Candida overgrowth. The principles of this diet include the following:
- Low carbohydrate intake: Decrease the intake of fruit, grains, and processed sugar.
- Limit gluten and other grains.
- Avoid dairy products (cheese, milk, cream).
- Avoid alcohol.
- Avoid processed meats and processed fats (canola oil).
Healthy foods that decrease the growth of Candida include:
- Non-starchy vegetables: Cruciferous vegetables, spinach, kale
- Low-sugar fruits: Lemons, limes, avocados
- Healthy proteins: Chicken, meat, eggs
- Healthy fats: Olive & coconut oil
- Fermented foods: Kefir, sauerkrautΒ
Probiotics and Gut Health
Probiotics are beneficial bacteria that support human health in various ways. The gut microbiome contains trillions of microorganisms naturally present within the gut. Different strains of probiotics have different benefits; however, in general, probiotics are used to modulate the gut microbiome by reducing pathogenic bacteria and improving the presence of beneficial bacteria.Β
Many studies have shown that probiotics are effective in diminishing the growth of Candida infections. Supplementation with Lactobacillus acidophilus probiotics is one potential treatment for limiting Candida colonization in the gut. Other strains of probiotics, such as Lactobacillus rhamnosum, Bifidobacterium bifidum, and Saccharomyces boulardii, have shown promising benefits in limiting candida overgrowth.Β
Lifestyle Modifications
Certain lifestyle habits such as poor sleep, smoking, chronic stress, and prolonged antibiotic use can lead to an impaired immune system, which may promote Candida overgrowth.Β
Chronic stress has been shown to decrease beneficial bacteria in the gut, resulting in dysbiosis and fungal overgrowth. Implementing stress reduction techniques such as yoga and meditation can help manage fungal overgrowth.Β
While antibiotics are sometimes crucial in health care, long-term use has been associated with decreased beneficial Bacteroidetes and increased Candida species. Implementing probiotics after antibiotic therapy is critical to maintaining good gut health.Β
Lack of physical activity is linked to systemic inflammation. Implementing regular physical exercise has been shown to boost the immune system and lower systemic inflammation. Moderate exercise has been shown to boost the immune system against Candida albicans.Β
Pharmaceutical Treatments for Candida
Antifungal Medications
In some cases, pharmaceutical antifungals may be needed. The most common medications for candida infections are fluconazole, itraconazole, and nystatin. More severe Candida infections may be treated with terbinafine, amphotericin B, or posaconazole.Β
- Fluconazole (Oral dosing): 800 mg loading dose followed by 400 mg daily
- Nystatin (Oral dosing): 100,000 units 3x per day for 6 weeks
- Itraconazole (Oral dosing): 200-400 mg per day for 4-6 weeks
Risks and Side Effects
Potential side effects of anti-fungal therapy include:
- Abdominal pain
- Upset stomach
- Diarrhea
- Itchy skin
- Liver damage (rare)
- Allergic skin reactions
When to Use Pharmaceuticals
Pharmaceutical treatment of candidiasis is needed in patients with a compromised immune system, invasive candidiasis (candidemia), the elderly, or those with recurring infections.Β
Antifungal medication therapy should always be done under the supervision of a doctor. The proper treatment is selected on an individual basis, taking into account the patient's medical history, type of infection, and immune status.Β
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Key Takeaways
- Candida albicans is the most common species of Candida to cause disease in the human body, affecting the GI tract, vagina, oral cavity, or skin.
- Candida overgrowth in the GI tract leads to symptoms of belching, bloating, abdominal pain, diarrhea, fullness, and gas.
- Candida appears as white, yellowish, or mucus-like patches in the stool.
- It is essential to consult your doctor if you notice signs and symptoms of Candida overgrowth for proper workup and treatment
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