DIAGNOSING CANDIDIASIS
Part of the standard procedure for establishing that organisms in the gut are causing disease is to examine the patient’s stools for signs of that organism. Unfortunately, this is not very helpful in candidiasis. We all have some Candida in the gut, and patients supposedly suffering from candidiasis often show no more Candida cells in the stools than healthy people do – yet they respond well to anti-Candida treatment. It may be that Candida is overabundant, but that this does not show up in the stools because the yeast is attached to the gut wall in some way – perhaps in its hyphal form.
In the absence of a reliable test, the diagnosis of candidiasis has to be based solely on the symptoms reported. This is a rather unsatisfactory situation, but fortunately the treatment for Candida infestation (described below) is fairly innocuous, so it does not matter too much if it is sometimes given unnecessarily.
For many people, it may be difficult to distinguish candidiasis from food intolerance at the outset, because the two have a great deal in common, at least in the symptoms they cause. Previous Candida infections, such as recurrent vaginal thrush, are a strong clue, but they are not infallible. Some women patients who are plagued by thrush turn out not to have candidiasis, despite many likely symptoms. Others with no history of thrush, and no abdominal bloating or wind, turn out to have candidiasis. The only sensible course of action is to decide which is the more likely and try the treatment for that problem first. In general, someone with food intolerance will respond to an elimination diet within a week, whereas someone with candidiasis may take much longer to respond to an anti-Candida diet – the response is also more gradual and less dramatic. So if there is any doubt, it is probably best to start with the elimination diet procedure. The first stage of this involves cutting out sugar anyway, so the simplest type of Candida problem will be sorted out during that stage. If there is no reponse to either Stage 1 or Stage 2, then go on to the anti-Candida diet. If this has no effect, then it may be worth trying Stage 3 of the elimination diet.
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