Chronic intestinal candidiasis, known as intestinal candidosis, is now a common health issue affecting an increasing number of people worldwide. One of the main reasons for this is the widespread use of antibiotics, which are often prescribed as the first-line treatment in many diseases, potentially leading to negative consequences for human health in the future.
Intestinal candidiasis: Disruption of gut microbial balance
The primary causative agent of fungal infections within the gastrointestinal tract is the genus *Candida*, with *Candida albicans* being the most pathogenic species among them. Of the approximately 200 identified species of this yeast globally, only fifteen exhibit the capacity to induce disease in humans. *Candida* comprises unicellular, yeast-like microorganisms that reproduce through cellular division or budding. Under physiological conditions—in individuals with a well-balanced gut microbiome—their presence should not typically lead to pathological developments. Naturally, they colonize various regions of the human body, including the oral cavity, colon, vaginal mucosa, and skin, where they participate in metabolic processes such as carbohydrate fermentation under normal circumstances. However, when an imbalance occurs between the *C. albicans* population and other intestinal microorganisms, the result is intestinal candidiasis—a condition in which yeasts become the dominant component of the gut flora, displacing beneficial bacteria. Under favorable conditions (e.g., compromised immune response), *Candida* can proliferate uncontrollably, deviating from the norm and leading to a multitude of health complications. In a healthy individual, *Candida* constitutes merely 1–2% of the total microbiota; however, in cases of dysbiosis, its proportion may surge to as much as 60–70%. Such infections are predominantly endogenous in origin, though human-to-human transmission and nosocomial infections are also possible. Key factors contributing to the overgrowth of *Candida* include chronic antibiotic therapies (which eliminate not only pathogens but also beneficial bacteria), the use of immunosuppressive drugs, cytostatics, and glucocorticoids, hormonal contraception, a diet rich in refined sugars, trans fats, and dairy products, malabsorption syndromes, chronic stress, advanced age, disruption of the intestinal epithelial barrier, and comorbid conditions such as diabetes mellitus, AIDS, malignancies, bronchial asthma, or autoimmune disorders. Broad-spectrum antibiotics destroy not only harmful microorganisms but also those that support health, leading to dysbiosis and secondary *Candida* overgrowth. For this reason, probiotic supplementation—both during and after antibiotic treatment—is essential to restore microbial equilibrium. Under conducive conditions, *Candida albicans* spreads uncontrollably, damaging the intestinal mucosa, degrading villi, increasing gut wall permeability (which facilitates the translocation of food allergens into the bloodstream), and reducing the surface area available for nutrient absorption, as substantiated by extensive clinical research [1].
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