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Candida Esophagitis

Last updated Nov. 15, 2019

Approved by: Maulik P. Purohit MD, MPH

Candida Esophagitis is a fungal infection of the food pipe (esophagus), caused most commonly by the yeast Candida albicans.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Esophageal Thrush
  • Infection of Esophagus by Candida
  • Monilial Esophagitis

What is Candida Esophagitis? (Definition/Background Information)

  • Candida Esophagitis is a fungal infection of the food pipe (esophagus), caused most commonly by the yeast Candida albicans. This esophageal infection may sometimes be caused by non-albicans species of yeast too
  • Candida species are normally found in the mouth, gastrointestinal tract, vagina, as well as the skin of a normal healthy person. They usually do not cause any infection in healthy individuals. However, in those with AIDS or cancer patients receiving chemotherapy, it takes advantage of the damaged immune system to cause Candida Esophagitis
  • The common symptoms associated with the infection include painful/difficult swallowing and burning chest pain. An upper GI endoscopy with biopsy (tissue examination of the esophagus by pathologist) is required for an accurate diagnosis of Candida Esophagitis
  • The infection can be easily treated, when underlying medical conditions are favorable. Fluconazole (an anti-fungal medication) is the first line of treatment for Candida Esophagitis. The prognosis may be severely affected in individuals whose immune systems are highly compromised

Who gets Candida Esophagitis? (Age and Sex Distribution)

  • Candida Esophagitis can affect individuals of any age. But, individuals whose immune systems are weakened by immunodeficiency infections, other debilitating conditions, or had had recent organ transplants are easily prone to the infection
  • Healthy individuals are not normally affected by Candida Esophagitis. Individuals at an advanced age and/or with an impoverished health status, are more at risk for infection

What are the Risk Factors for Candida Esophagitis? (Predisposing Factors)

Candida Esophagitis is an opportunistic infection. The risk factors may include:

  • Patients, who have undergone any organ or bone marrow transplantation (since they may be on immuno-suppressant drugs)
  • Patients undergoing treatment for, or suffering from acute viral infections such as HIV and AIDS (due to reduced blood lymphocyte count causing decreased immunity)
  • Individuals undergoing kidney dialysis for a prolonged period
  • Those undergoing chemotherapy for cancer
  • Individuals on long-term corticosteroid therapy (either low or high dosage) for a variety of health issues
  • Conditions, such as malnutrition, alcoholism, and diabetes, are also associated with Candida Esophagitis
  • Babies, who are born vaginally, can also develop the infection, if their mothers had had vaginal yeast infection of candida

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Candida Esophagitis? (Etiology)

Candida Esophagitis is caused by the fungus Candida albicans.

  • The condition is indicative of a frail immune system that may be due to any medical condition or viral infection such as HIV infection or AIDS
  • Candida is normally found in the oral cavity of up to two-thirds of the healthy human population

What are the Signs and Symptoms of Candida Esophagitis?

Common signs and symptoms associated with Candida Esophagitis include:

  • Ulcerous sores on the surface of esophagus (food pipe) making it painful and difficult to eat, drink, or swallow
  • Loss of appetite
  • Burning chest pain behind the breastbone
  • Mild fever
  • Weight loss
  • Candida Esophagitis is almost always accompanied by oral candidiasis (oral infection by Candida)

Young children unable to describe their pain or discomfort may present with the following symptoms:

  • Feeding difficulties
  • Failure to thrive

How is Candida Esophagitis Diagnosed?

Diagnostic tests that are performed for Candida Esophagitis may include:

  • Physical examination with evaluation of detailed medical history
  • Esophagogastroduodenoscopy (EGD) test: It is an examination of the esophageal tract by using an endoscope. A tissue biopsy of esophagus is performed during the EGD. The esophageal biopsy is sent to the laboratory for examination by a pathologist. The pathologist may also perform additional special tests to confirm the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Candida Esophagitis?

Complications of Candida Esophagitis include:

  • Narrowing of the esophagus; stricture formation
  • Perforation of the esophagus
  • Spread of infection to other sites in the body causing infections such as Candida vaginitis (infection of the vagina) and Candida enteritis (infection of the intestine)
  • Recurrence of the infection
  • Side effects from the medications used to treat Candida Esophagitis

How is Candida Esophagitis Treated?

A quick or early diagnosis and appropriate treatment is the key to speedy recovery from Candida Esophagitis. Surgical procedures are not required to treat the condition; a prompt treatment with antifungal medications is generally adequate.

  • Fluconazole, an antifungal medication, given orally is the first line of treatment against Candida Esophagitis
  • Sometimes, other antifungal medications, such as nystatin, caspofungin, and amphotericin, can also be used, depending on the health status of the individual and spread of infection
  • Pain-relieving medications are also used to ease the pain and provide comfort to the patient

How can Candida Esophagitis be Prevented?

Candida Esophagitis, most of the time, occurs along-with oral candidiasis (infection of the oral cavity by candida). Although, both can be avoided by practicing the following measures (especially in those with a compromised immune system):

  • Maintaining good oral hygiene
  • Frequent mouth rinsing, especially after eating sugary and starchy foods
  • Cleaning the mouth with a good mouthwash, multiple (2-3) times a day, as required

An effective treatment of AIDS affected individuals using antiretroviral therapy (drug cocktail for AIDS patients) can also keep HIV infection under control and prevent the onset of other opportunistic infections, including Candida Esophagitis.

What is the Prognosis of Candida Esophagitis? (Outcomes/Resolutions)

  • Candida Esophagitis can be effectively treated when the underlying medical conditions remain favorable
  • If the immune system of the individual is severely compromised or if there are other complications, then the prognosis may be adversely affected
  • A healthy immune system recovers faster, with little or no treatment

Additional and Relevant Useful Information for Candida Esophagitis:

The Candida species causes a host of other diseases in those who are rendered vulnerable due to a weak immune system.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 26, 2014
Last updated: Nov. 15, 2019