A CASE PRESENTATION OF INTESTINAL CANDIDIASIS CAUSING IRRITABLE BOWEL SYNDROME AND PERIPHERAL NEUROPATHY

Purpose: To demonstrate the role of candidiasis in Irritable Bowel Syndrome (IBS), investigate the possibility of intestinal candidiasis causing periphery neuropathy, and encourage clinicians to consider intestinal candidiasis in patients with symptoms of IBS. Methods: A clinical case of IBS with peripheral neuropathy is investigated. The 35yo man of Mediterranean descent complained of persistent diarrhea, diffuse abdominal pain, generalized myalgia, and parenthesis in extremities. Stools were loose, watery, foul smelling, and yellowish in color. There was no melena. He occasionally had constipation. Dicyclomine provided mild relief during episodes of severe diarrhea. Myalgias were most severe in lower lumbar region, radiating to his extremities. Tramadol provided moderate relief. He also felt weakness, numbness, and tingling in his face, hands and feet Symptoms had been waxing and waning for over 6 years, but worsened over the last year. 6 years ago, he was diagnosed with IBS after a negative EGD and colonoscopy (some evidence of diverticulosis). Results: Labs and imaging tests ruled out celiac disease, diabetes, thyroid disease, mineral deficiency, metal poisoning, autoimmune disorders, Lyme disease, syphilis, and structural abnormalities. The patient was advised keep a food diary. Over a month of carbohydrate and sugar restriction, he had significant relief of his symptoms. His abdominal pain and diarrhea had largely resolved since the diet change. He still experienced occasional parenthesis in extremities. Acquired carbohydrate intolerance due to intestinal candidiasis was suspected. He was treated with Diflucan for 30 days. Along with medication, he was also advised to supplement with probiotics and eat a healthy diet with continued carbohydrate and yeast restriction. The patient has remained symptom-free except for residual peripheral neuropathy since the treatment. Conclusions: Candida albican is a normal gastrointestinal microbial in healthy humans, but during immunosuppression or alteration of bacteria microbiota, such as following broad-spectrum antibiotic treatment or chronic vaginal candidiasis, C. albicans can overgrow and suppress the healthy bacterium of the colon, resulting in abdominal pain and diarrhea. It is also suspected that candidiasis can cause peripheral neuropathy due to overproduction of alcohol. Treatment is anti-fungal medication. A healthy, low-carb diet and probiotic supplements are also essential to maintain intestinal health and prevent recurrence.