Candida Esophagitis

Candida esophagitis is a yeast infection in the tube that carries food from the mouth to the stomach (esophagus). The yeast infection (Candida) is the same fungus that causes oral thrush and vaginal yeast infections; and it tends to grow when the body’s ability to fight infection is already weak from illness.

Cause

Candida esophagitis is usually caused when the body is weak from infection with the immune system-compromising virus (HIV) that causes AIDS. Having this infection does not mean AIDS will develop. Candida infection can also be caused by:

  • Cancer and the chemotherapy used to treat cancer.
  • Poorly controlled diabetes
  • Poor nutrition
  • A chronic illness
  • Drug or alcohol abuse
  • Organ transplants
  • Other conditions that prevent or weaken the immune system.

Symptoms

Symptoms include:

  • Difficulty in swallowing
  • Painful swallowing
  • Oral thrush (Candida of the mouth)
  • Nausea
  • Loss of appetite.

Diagnosis

Tests that are done:

  • Endoscopy (EGD) to view the esophagus and take a sample of tissue (biopsy) to exam under the microscope.
  • Mouth or throat swab culture
  • Upper GI and small bowel series.

Treatment

The goal is to kill the fungus using antifungal medicines. Oral anifungal treatment can control the infection. Some people also need pain medicine. Many patients need other, long-term medicines to suppress the fungus and prevent it from coming back. Choices of medication include:

  • Nystatin swish and swallow
  • Fluconazole or ketoconazole (both are antifungal medicines taken by mouth)
  • Amphotericin and/or flucytosine (for HIV and infections in the blood system).

If the symptoms are bad, a hospital stay may be needed for treatment.

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