Though it’s unclear whether Candida plays a causal role, researchers have found low or altered fungal diversity in patients with inflammatory bowel disease (IBD),[1] and emerging evidence indicates that Candida species tend to predominate in the mycobiomes of patients with IBD.[2]
Some species of Candida can colonize and delay the healing of gastric and intestinal ulcers. One small observational study found that certain species were detectable in inflamed regions of the intestines in Crohn’s disease but absent from the non-inflamed areas.[3] One nonrandomized, uncontrolled study reported that two weeks of antifungal treatment in patients with ulcerative colitis and significant fungal colonization reduced disease activity and mucosal inflammation.[4]
Without diagnostic criteria or the quantification of Candida colonization in these studies, however, it’s impossible to determine whether these cases would be characterized as IC or some form of fungal imbalance. Patients with IBD often use certain medications that increase the risk for fungal disease, which could also explain these findings.[5]
Candida abundance is also associated with visceral hypersensitivity (a heightened sense of pain in response to normal gut functions) in a subgroup of IBS that responds well to antifungal treatment.[6] Exploratory studies have noted that higher Candida abundance is associated with more severe bloating.[7] Though Candida species are present in people with and without IBS, other emerging evidence suggests that C. albicans in people with IBS is genetically distinct from the same species in healthy people. The correlations between Candida and certain bacteria also differ between people with IBS-D and healthy controls.[8] There is still no conclusive link between IBS and Candida, though. Despite some unique variations in IBS versus healthy controls, the mycobiome isn’t a useful biomarker for IBS due to high levels of individual variability and lack of any causal relationships.
References
- ^Hoarau G, Mukherjee PK, Gower-Rousseau C, Hager C, Chandra J, Retuerto MA, Neut C, Vermeire S, Clemente J, Colombel JF, Fujioka H, Poulain D, Sendid B, Ghannoum MABacteriome and Mycobiome Interactions Underscore Microbial Dysbiosis in Familial Crohn's Disease.mBio.(2016-09-20)
- ^Christel Chehoud, Lindsey G Albenberg, Colleen Judge, Christian Hoffmann, Stephanie Grunberg, Kyle Bittinger, Robert N Baldassano, James D Lewis, Frederic D Bushman, Gary D WuFungal Signature in the Gut Microbiota of Pediatric Patients With Inflammatory Bowel DiseaseInflamm Bowel Dis.(2015 Aug)
- ^Qiurong Li, Chenyang Wang, Chun Tang, Qin He, Ning Li, Jieshou LiDysbiosis of gut fungal microbiota is associated with mucosal inflammation in Crohn's diseaseJ Clin Gastroenterol.(2014 Jul)
- ^M Zwolińska-Wcisło, T Brzozowski, T Mach, A Budak, D Trojanowska, P C Konturek, R Pajdo, D Drozdowicz, S KwiecieńAre probiotics effective in the treatment of fungal colonization of the gastrointestinal tract? Experimental and clinical studiesJ Physiol Pharmacol.(2006 Nov)
- ^George A Stamatiades, Petros Ioannou, George Petrikkos, Constantinos TsioutisFungal infections in patients with inflammatory bowel disease: A systematic reviewMycoses.(2018 Jun)
- ^A Das, E O'Herlihy, F Shanahan, P W O'Toole, I B JefferyThe fecal mycobiome in patients with Irritable Bowel SyndromeSci Rep.(2021 Jan 8)
- ^Piero Sciavilla, Francesco Strati, Monica Di Paola, Monica Modesto, Francesco Vitali, Duccio Cavalieri, Gian Maria Prati, Maura Di Vito, Giovanni Aragona, Carlotta De Filippo, Paola MattarelliGut microbiota profiles and characterization of cultivable fungal isolates in IBS patientsAppl Microbiol Biotechnol.(2021 Apr)
- ^Gaichao Hong, Ying Li, Min Yang, Gangping Li, Wei Qian, Hanhua Xiong, Tao Bai, Jun Song, Lei Zhang, Xiaohua HouGut fungal dysbiosis and altered bacterial-fungal interaction in patients with diarrhea-predominant irritable bowel syndrome: An explorative studyNeurogastroenterol Motil.(2020 Nov)