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Gastroenterologist

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Candidiasis of the esophagus, stomach and intestines

Alexey Kryvenko, medical expert
Last reviewed: 07.07.2025

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The most common variant is esophageal candidiasis; specific lesions of the stomach and intestines are rare. In patients in the intensive care unit, candidiasis or colonization of the gastrointestinal tract may be the cause of invasive candidiasis.

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Risk factors

Use of antibacterial drugs, glucocorticoids, immunosuppressants and cytostatics, neutropenia, AIDS, diabetes mellitus, malignant diseases, achalasia, diverticulosis and surgical treatment of the esophagus.

Symptoms of candidiasis of the esophagus, stomach and intestines

Esophageal candidiasis is characterized by pain, discomfort when swallowing, especially hard or hot food, and discomfort behind the breastbone unrelated to food intake. Esophagogastroduodenoscopy reveals hyperemia, contact vulnerability, and fibrinous deposits. The lesion is localized mainly in the distal parts of the esophagus. The severity of clinical and endoscopic signs depends on the severity of immunodeficiency. Esophageal candidiasis can be complicated by esophageal stenosis, bleeding, and perforation.

Gastric candidiasis occurs rarely, mainly as a complication of an ulcer or tumor of the stomach, or surgical intervention.

Intestinal candidiasis occurs mainly against the background of taking high doses of cytostatics in cancer patients. The role of Candida spp. in the development of diarrhea, including that occurring after the use of antibacterial drugs, has not been proven.

Diagnostics

The diagnosis is based on the detection of budding cells, pseudomycelium of Candida spp. in the material obtained during endoscopic examination. Patients with a high risk of invasive candidiasis (the presence of risk factors, clinical signs) are shown additional examination.

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Treatment of candidiasis of the esophagus, stomach and intestines

The basis of treatment is the use of systemic antimycotics; non-absorbable antimycotics (nystatin, etc.) are ineffective. The drug of choice is fluconazole; its use is effective in 80-95% of patients. If fluconazole is ineffective, amphotericin B, caspofungin, and voriconazole are used.