![]() Overall, any gut mycobiome study requires careful and detailed experimental design. We would also need to perform stool measures not typically performed in the clinic to better correlate fungal overgrowth with GI-related symptoms. For instance, what is the gut mycobiome composition among people not suffering from GI-related symptoms? Efforts to answer these questions would require longitudinal sample collection to account for the high turnover of microbes in the GI tract. ![]() The few studies that have examined the human gut mycobiome expose the need to answer basic questions about the fungal components of the gut microbiome. Studying the gut mycobiome for further insights So, it’s not yet clear whether mycobiome differences exist across populations with IBS. A smaller study done on a Dutch cohort, on the other hand, detected significantly reduced total fungal diversity among IBS patients 4. However, no significant differences in the number of fungal species were observed between IBS patients and volunteers. This effort revealed DNA sequences belonging to many fungal species. In line with this movement, my colleagues at Cork investigated the fungal members of the gut microbiome – that is, the gut mycobiome – in the guts of patients diagnosed with irritable bowel syndrome (IBS) 3 to ascertain whether there was any correlation with symptoms. The gut microbiome has taken centre stage in common discourse about gut health. However, the lack of documentation of response to an antifungal treatment protocol makes it difficult to attribute the observed symptoms to the presence of fungal organisms. A study examining small intestinal fungal overgrowth identified instances of fungal overgrowth among 150 patients with unexplained symptoms 2. Other studies on the matter lack the clinical evidence to conclude that fungal infections drive GI disease. These patients suffered from chronic illness, underwent intense antimicrobial treatment or chemotherapy, and faced severe outcomes such as dehydration-and clinicians consistently identified the growth of Candida albicans in the patient fecal samples. One study published in the 90s reported 10 patients hospitalized with severe diarrhea 1. Regardless, instances of documented Candida infection in the GI tract remain few in number. Immunocompromised patients also face a greater risk of Candidiasis and Candidemia-these include HIV patients patients undergoing chemotherapy transplant patients and patients suffering from malnutrition.įungal infections are rare in the GI tract Patients taking oral or inhaled steroids may develop Candida infections in the oropharynx and esophagus. Fungal infections, from Candida or other fungi, frequently occur on the nails or skin. This is not to say that fungal infections do not take place in the body. Much of the misinformation I encounter on Candida infections focuses on selling a story that encourages people to blame Candida overgrowth as the cause of their symptoms and undertake expensive or complicated dietary and supplement regimens to “cure” the infection. In a 2021 ISAPP presentation on the gut mycobiome, I provided a clinical perspective on fungal infections and the related evidence base. Some articles aim to counter the hype – for example, an article titled “Is gut Candida overgrowth actually real, and do Candida diets work?” Yet patients are too often confused about the evidence on Candida and other fungi in the GI tract. ![]() Even cookbooks exist with recipes specifically tailored to “cure” someone of Candida infection through dietary changes. Their insistence is perhaps not surprising, given how many many websites and social media ‘gurus’ share lists of symptoms supposedly tied to Candida infections. Patients experiencing a range of symptoms, including digestive problems, sometimes believe they have an overgrowth of Candida in their gastrointestinal (GI) tract and want to know what to do about it. Eamonn Quigley, MD, The Methodist Hospital and Weill Cornell School of Medicine, HoustonĪs a gastroenterologist, I frequently meet with patients who are adamant that a Candida infection is the cause of their ailments.
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