A 32 year old man goes to doctor, complains of bloating or feeling of stomach fullness and acid reflux. The first thing that doctor considered was a perforated gastric ulcer. Doctor thought twice when he asked him, if he feels pricking pain in the epigastrium and the man answered that there was none. He has no history of surgery and no known diseases. He said he works in the Thailand as a manager. He also admitted that he has a history of IV drug use. Doctor did physical examination. Upon auscultation of the abdomen, there was hyperactivity. Doctor searched further towards the mouth. When he opened his mouth, doctor saw numerous white ulcers in his gums , inner lips and in the root of the tounge. It was Candidiasis or commonly known as oral thrush.
Laboratory test are useless in confirming Candida. The most reliable diagnostic tool for this is a prompt clinical history and a thorough phusical exam. Bloating due to Candida overgrowth has these following signs and symptoms. Diarrhea that is caused by mucosal irritation. Bloating caused without pain, acid reflux without epigastric pain, can have fever, may have vomiting, will always have oral candidiasis upon examination and a positive history of immunocompromised state.
Candida albicans is a yeast. It is a normal flora in many parts of the body including the oropharynx. However, when it starts to grow peculiarly fast that it starts to invade the system, known as overgrowth, it will cause problems. The overgrowth of Candida albicans in the GIT does not cause obstruction but rather, what causes bloating is the gaseous material they produce.
Bloating is seen in Chronic, untreated Candidiasis. Infection usually starts as ulcers in the oral cavity known as thrush. As we swallow saliva, we swallow with it candida into the Upper gastrointestinal tract. As the yeasts reach the intestines, they grow in colonies and as they grow they immit acid gases as byproducts. These acids accumulate in the GIT which gives the feeling of fullness or bloating.
Candidiasis does not commonly cause bloating and it seldom reach the Upper Gastrointestinal tract. Healthy individuals may only have oral thrush for a day or two because their immune system is intact. However, in those who are immunocompromised, the effects of Candida overgrowth may reach the GIT to the lungs. Some cases of Candiasis even start in the vaginal oriface. Candida albicans is considered as the second most common cause of fungal infection causing mortality in HIV patients. It is also one of the top causes of nosocomial and healthcare acquired diseases.
Treatment for Candidiasis is Antifungal and not Antibiotics. This should go with fluid replacement and supplements to boost up the immune system of the body. Fiber riched none fatty food is also recommended to promote proper digestion. In some countries, Candida overgrowth with bloating is considered a sign of immunodeficiency and that patients are advised to have more intensive diagnostic tests.
Resources for citation