Small Intestinal Fungal Overgrowth

Abstract

Small intestinal fungal overgrowth (SIFO) is characterized by the presence of excessive number of fungal organisms in the small intestine associated with gastrointestinal (GI) symptoms. Candidiasis is known to cause GI symptoms particularly in immunocompromised patients or those receiving steroids or antibiotics. However, only recently, there is emerging literature that an overgrowth of fungus in the small intestine of non-immunocompromised subjects may cause unexplained GI symptoms. Two recent studies showed that 26 % (24/94) and 25.3 % (38/150) of a series of patients with unexplained GI symptoms had SIFO. The most common symptoms observed in these patients were belching, bloating, indigestion, nausea, diarrhea, and gas. The underlying mechanism(s) that predisposes to SIFO is unclear but small intestinal dysmotility and use of proton pump inhibitors has been implicated. However, further studies are needed; both to confirm these observations and to examine the clinical relevance of fungal overgrowth, both in healthy subjects and in patients with otherwise unexplained GI symptoms. Importantly, whether eradication or its treatment leads to resolution of symptoms remains unclear; at present, a 2-3-week course of antifungal therapy is recommended and may be effective in improving symptoms, but evidence for eradication is lacking.

Diversity of Fungi in the Public Hand-pump Borehole Water in Onueke, Ezza Local Government Area, Ebonyi State, Nigeria

“…All the isolates were resistant to the drug Griseofulvin. Similar resistance pattern has been reported by Olajuba and Ogunika [21].Candida albicans is a dimorphic fungus and one of the genera that cause candidiasis in humans [22] and is responsible for 50-90% of all cases of candidiasis of humans. It is a flora of the human gastrointestinal tract and is detectable in the gastrointestinal tract in 40% of healthy adults [23].…”

Food quality affects the expression of antimicrobial peptide genes upon simulated parasite attack in the larvae of greater wax moth

“…A recent study showed that host and symbiont communities cooperatively interact to maintain the midgut microbiota in a symbiotic balance (Johnston & Rolff, 2015), suggesting that the host needs more control over symbionts by means of AMP proteins. Symbionts may become pathogenic if they grow and reproduce uncontrollably, diverting resources away from growth and other needs of the host if not controlled by the host's immune system (Erdogan & Rao, 2015;Fujimori, 2015). Importantly, the food of G. mellonella was not sterilized in this study, which makes it possible that resident microbes in the gut may be flushed away by a downstream flow of ingested content (Nyholm & McFall-Ngai, 2004;Blum et al, 2013) and replaced by opportunistic or pathogenic bacteria (Jones et al, 2013;Cariveau et al, 2014).…”

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

“…This has been difficult to verify due to the lack of specific symptoms (belching, bloating, indigestion, nausea, diarrhea, and gas) and lack of diagnostic tests. Patients considered at risk for this type of candidiasis include cancer and transplant patients receiving immunosuppressive therapy or prolonged antibiotic prophylaxis, and therefore this represents a disease associated with impaired host immunity (104,105). At the other end of the host response spectrum, experimental and clinical evidence also suggests that GI tract C. albicans colonization may be a cofactor for inflammatory diseases, which could be considered host-mediated damage.…”