Sore throat

Updated 24 August 2016

Oesophagitis candida

Oesophagitis candida is a fungal infection of the oesophagus.

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Summary

  • Oesophagitis candida is a fungal infection of the oesophagus.
  • It is caused by the same fungus that causes thrush and vaginal yeast infections.
  • It usually occurs in people with a suppressed immune system, especially people with HIV/AIDS.
  • Its symptoms include painful swallowing, and it is often accompanied by oral thrush.
  • It can be treated with antifungal medication.

Alternative names

Candida infection, yeast infection, oesophageal candidiasis, monilial oesophagitis, and candidal oesophagitis

What is oesophagitis candida?

Candidal oesophagitis is a fungal infection (or yeast infection) of the oesophagus, the passage leading from the mouth to the stomach. The candida fungus also causes the related conditions of oral thrush (in the mouth and throat) and candida vaginitis (in the vagina).

What causes oesophagitis candida?

Oesophagitis candida is caused by the fungus candida (most often the species Candida albicans, although other species may be implicated). The fungal growth often starts as oral thrush and spreads from the mouth down the oesophagus. Candida occurs normally and harmlessly in the mouth, digestive tract and female genital tract. It is only problematic when there is excessive fungal growth, which is usually a result of a weakened immune system, particularly in people with HIV/Aids. Oesophagitis candida is one of the defining symptoms of Aids.

Other conditions can suppress the immune system and make one susceptible to oesophagitis candida. These include:

  • Chemotherapy treatment,
  • Diabetes,
  • Leukaemia,
  • Lymphoma ,
  • Use of immune-suppressing medication (for example with an organ transplant), and
  • Antibiotic use.

Women are somewhat more likely than men to experience the condition.

Symptoms

These include:

  • Difficult, painful swallowing ,
  • Nausea,
  • Oral thrush,
  • Weight loss, and
  • Pain in the chest, or the feeling of food getting stuck in the chest.

Diagnosis

Oesophagitis candida is often diagnosed on the basis of the symptoms. There are several additional methods of confirming the diagnosis:

  • Endoscopy: a thin fibre-optic scope is passed into the upper digestive tract via the mouth, in order to view the oesophagus and take samples;
  • Throat swab: used to take samples to test for candida in the throat; and
  • Barium swallow: the patient drinks a fluid that coats the inner surface of the oesophagus and shows up on X-rays.

Treatment

Candida is usually treated by antifungal medication:

  • Topical antifungal mouthwashes or lozenges can treat oral candida, but are usually not very effective in the oesophagus.
  • More effective are oral antifungal medicines that are systemic (act throughout the body), such as fluconazole.
  • If these don't help, intravenous antifungal medication such as amphotericin may be used.

Prognosis

Oesophagitis candida can usually be successfully treated. However, as is usually the symptom of an underlying immune-system disorder, the body will continue to be susceptible to fungal infection. Such immune system disorders can be controlled with other medication, for example antiretroviral medications in the case of HIV/Aids.

Complications

  • Infection may recur.
  • The fungus may spread to other parts of the body.
  • Holes in the oesophagus may develop.
  • Certain antifungal medications have side-effects.

When to call your doctor

See your doctor if you develop symptoms, especially if have a weakened immune system.

How can it be prevented?

It is not possible to eradicate candida, because it occurs naturally in the body. However, it is possible to control its growth and prevent candidiasis from developing.

  • Keep the immune system strong. Antiretroviral therapy can keep HIV under control.
  • Avoiding sugars and starchy food may be beneficial.
  • Eating yoghurt containing "live" bacterial culture may also help to control the fungus.
  • Good oral hygiene is important.
  • People who have a suppressed immune system may choose to take oral antifungals as a preventive measure. However, this should be done with caution, as constant use of antifungals may encourage the development of treatment- resistant candidiasis.

 

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