Z Arztl Fortbild Qualitatssich

[Fungi in the intestine--normal flora or pathogens?]

Year 1998
Bernhardt H.
Klinik fur Innere Medizin A, Ernst-Moritz-Arndt-Universitat Greifswald.
Candida spp. und C. albicans are common within the microbial ecosystem of the human orointestinal tract. Candida in low quantities is found at various sites in healthy subjects. In patients with typical risk factors, mainly in immunocompromised hosts, an increased growth of Candida occurs. In cases with multiple sites colonised there will be an increased risk of severe Candida infections. The metabolic activity of Candida in the gut is very low under anaerobic condition and limitation of nutrients.

[Fungi in the oro-intestinal tract and their scientifically founded status]

Year 1998
Knoke M.
Klinik fur Innere Medizin A, Ernst-Moritz-Arndt-Universitat Greifswald.
The orointestinal tract is a reservoir for facultatively pathogenic fungi, especially Candida albicans. In all of its sections in immunocompromised hosts, the occurrence of a mucosal mycosis is possible which may be the starting point of an infection of internal organs. The mouth and esophagus are the most often affected locations. A synopsis of clinical (including endoscopic) findings, mycological cultivation and mycoserology is important in diagnostics. There is no connection between the incidence of Candida in the orointestinal tract and multiple local symptoms like fatigue, headache, heartburn and others called "candidiasis hypersensitivity syndrome" or "mycophobia".

[Clinical, diagnostic and pathogenetic aspects of reflux-associated cough]

Year 1998
Micklefield GH.
Medizinische Klinik, Ferdinand-Sauerbruch-Klinikum Wuppertal, Klinikum Wuppertal GmbH.
Gastroesophageal reflux may be responsible for atypical extra-esophageal symptoms, such as chest pain, dyspnea, chronic cough, or hoarseness. Prospective studies of gastroesophageal reflux have indicated reflux as the cause for chronic cough in 10 to 20% of patients. The precise mechanism by which reflux causes cough remains uncertain, although the possibility that the cough is caused by stimulation of the esophageal mucosa receptors rather than aspiration is suggestive from some studies. Prolonged esophageal pH monitoring affords an opportunity to document objective gastroesophageal reflux. Furthermore, pH monitoring gives the opportunity to correlate temporally acid reflux events with the onset of certain symptoms.