Are fungi found in the stool actually present in the intestine.

[kiny]

It seems like an odd question. By asking this you are challeging the notion of a gut mycobiome consisting of fungi.

Most studies naturally assume that when fungi like Candida spp and Malassezia are found in stool of patients with crohn's disease, that they have colonized the gut where they elicit a chronic immune response.

But there's reason to assume this is not the case. There's reason to assume these are simple transient fungal passengers that simply evoke a transient immune response.

Fungi are quite poor colonisers of the gut, due to competition from bacteria that are more flexible and can sustain higher temperatures. Most fungi are completely incapable of colonizing the gut and the diversity of species we find in stool samples are very limited, notably Candida, Saccharomyces and Malassezia.

If fungi are causing an immune response in crohn's disease, but we are not colonized by them, where then do these fungi come from. The most straightforward explanation is that they come from the diet and the oral cavity. To this day, no one has been able to explain the aphthous ulcers in the mouth of crohn's disease patients.

What is so special about EN's ability to reduce inflammation. Why is this question unanswered. When inflammatory markers drop in 24 hours, can this really be explained by a change of the microbiome? Or might it have to do with the lack of fungal antigen.

Rutgeerts and later PH Harper showed that the fecal stream elicits a strong immune response in crohn's disease, but did not suggest colonisation of the GI tract as a culprit.

 

[Andersen007]

" Or might it have to do with the lack of fungal antigen. " - not sure about this one - I do sometimes have mild candiasis in my mouth in the last years, doesn't cause symptoms or ulcers really, but visible when I check in the mirror. It does become way more visible when I take EEN, I assume due to the amount of sugar that lingers in the mouth creating a good environment for it. But then again EEN never worked for me so this may not be the case for others.

 

[kiny]

Oral manifestation of the fungi Candida albicans on the tongue, or so-called "thrush", is common in crohn's disease patients, especially if patients are on immmunosuppressants.

If you see it immediately after consuming Elemental Nutrition, it could also be a case of residue from the EN sticking to the tongue, this is commonly seen in babies who drink formulas.

Good mouth hygiene, a tongue scraper, mouth wash like Listerine, or actual anti-fungal medication like itraconazole in oral solution could all help. Just drinking some peppermint tea is also beneficial.

Tea can be consumed with EN no problem, as Anthony Segal showed, subjects were allowed tea while on EN. Not only would it have been hard to deny UK tea lovers their favorite drink, it had absolutely no effect on the effectiveness of EN.

 

[wduk]

I get mouth ulcers and have oral thrush right now. I'm still convinced I have fungal in small bowel causing all this. I'm off all meds and going to ask doctor to go for anti fungal medication, will see if I improve.

 

[Andersen007]

I get mouth ulcers and have oral thrush right now. I'm still convinced I have fungal in small bowel causing all this. I'm off all meds and going to ask doctor to go for anti fungal medication, will see if I improve.

Keep us posted on how it goes!