Irritable Bowel Syndrome Message Boards | Re: The Candida question

Candida is a yeast that normally inhabits our digestive system: the mouth, throat, intestines and genital/urinary tract. Candida is a normal part of the bowel flora (the organisms that naturally live inside our intestines, and are not parasitic). It has many functions inside our digestive tract, one of them to recognize and destroy harmful bacteria. Without candida in our intestines we would be defenseless against many pathogen bacteria. Our immune system normally keeps candida under control, but anything that compromises the immune system (antibiotics, stress, fatigue, etc.) can permit candida to proliferate. When this happens, candidiasis can occur.

Candidiasis is identified in three major categories by the Center for Disease Control: oral, vaginal, and invasive. Oral and vaginal yeast infections do not result in IBS, or in symptoms that can mimic IBS.

While someone with invasive (systemic) candidiasis could have IBS-like symptoms (along with many others such as fever and chills), this is a serious, life-threatening illness of the entire bloodstream that can result in organ failure and death. Invasive candidiasis is diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope. People with invasive candidiasis are not likely to be walking around for months or years with nothing to show for it but intermittent bowel dysfunction - they're hospitalized and receiving IV anti-fungal drugs. The CDC candidiasis info is at these links:

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_g.htm
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_inv_g.htm
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/candidiasis_t.htm

There's another great link about various forms of candidiasis diagnosis and treatment at http://www.emedicine.com/EMERG/topic76.htm

The theory that a yeast overgrowth is behind a wide range of health problems, including gastrointestinal, is not new. The Yeast Connection was a huge best-seller back in the early '80s and more books on the same theory have followed since. The main problem I have with the "yeast theory" is that there haven't been any clinically controlled, double-blind, peer-reviewed studies showing any link to IBS and a candida overgrowth at all. After a good twenty years of expounding this theory I think the doctors supporting it should have something to show. The single research study I can find looking specifically at candida and IBS does not show a connection. This study is in:

Postgrad Med J. 1993 Jan;69(807):80.

The role of faecal Candida albicans in the pathogenesis of food-intolerant irritable bowel syndrome.

Middleton SJ, Coley A, Hunter JO.

Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.

Candida albicans was sought in stool samples from 38 patients with irritable bowel syndrome and 20 healthy controls. In only three patients with irritable bowel syndrome was C. albicans discovered and these patients had either recently received antibiotics or the stool sample had been delayed more than 24 hours in transit. C. albicans was isolated from none of the control stool samples. We conclude that C. albicans is not involved in the aetiology of the irritable bowel syndrome.

PMID: 1437926

On the other hand, there is now a wealth of evidence that IBS is a disorder of gastrointestinal motility, caused by problems in the enteric (gut) nervous system as well as that system's interaction with the brain. Two great links for this from the UNC Center for Functional GI & Motility Disorders (a multidisciplinary facility dedicated to advancing the understanding and care of patients with functional gastrointestinal disorders):

http://www.med.unc.edu/wrkunits/2depts/medicine/fgidc/historyfunctionaldisorders.htm

http://www.iffgd.org/symposium2001.html

I'd also add a side note here about hypnotherapy, which has been proven repeatedly to have an 80-90% success rate in treating IBS: hypnotherapy would logically help a nervous system and brain/gut motility disorder. I don't know how it would possibly help candida overgrowth. Great link for hypnotherapy and IBS is http://www.med.unc.edu/wrkunits/2depts/medicine/fgidc/hypnosis.htm

So, I personally don't give any weight to the candida theory for IBS, though my mind is open if research studies in this area find a connection.

As for diet, I would do what works best for you. IBS in way does not exist if you're not experiencing symptoms, in that even though the underlying pathology is still there, there is nothing actually going wrong with your GI tract when you're symptom-free. This is very different from most chronic illnesses, where you may temporarily feel fine but be experiencing silent physical damage from the disease (as with diabetes, high blood pressure, etc.). So if you can keep your IBS symptoms under control with a healthy diet (or stress management or yoga, etc.) you should in no way be causing some type of "hidden harm" to yourself.

Best,
Heather

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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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