: Re: Being candid about Candida ...

[Guest guest]

Hi , thank you very much for sending this information. I actually just bought the inexpensive book called the

The Candida-Yeast Syndrome. Kind of complicated for me but I bought it because I think that Candida is a problem and not good for the system. The author explains in detail why it is bad, the effects and what foods to avoid and what foods to enjoy.

The info you sent as always is very good information but kind of technical and I always seem to have a hard time understanding it all. From what I understand, it is saying that those tested and had Candida were 75% more likely to need a liver transplant??? If this is correct, it is amazing information. The question I have is "Why". I have not read the book completely yet, so I am not sure how it effects the liver or more importantly the bile. I don't understand what dominant stenosis is or treating endoscopically....? and I don't understand "Survival free of liver transplantation in patients without dominant stenosis at 18 years was 73.1% and of patients with dominant stenosis was 25.0% (p=0.011)." Maybe just

explaining the conclusion below will help me.

Conclusion: In patients with dominant stenosis?????, survival free of liver transplantation is reduced. Bacteria in bile do not worsen the outcome if dominant stenoses are opened endoscopically and infection is adequately treated with antibiotics???.

This I understand and to me is very exciting: Candida in bile is associated with a poor prognosis and these patients need liver transplantation relatively soon. At least I can suggest to my Dad to avoid any foods that would produce Candida and his need for a liver transplant might not happen or at least not for a longer time??? Interesting that the bacteria had little effect.

Any light you can shed on this would be appreciated.

Lori A.

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To: Sent: Saturday, March 28, 2009 12:31:09 AMSubject: Being candid about Candida ...

J. Hapatol. [in Press] (2009)Influence of dominant bile duct stenoses and biliary infections on outcome in primary sclerosing cholangitis.Gerda Rudolph, Gotthardt, Petra Klöters-Plachky, Hasan Kulaksiz, Rost, Adolf StiehlDepartment of Medicine, University of Heidelberg, Medizinische Universitätsklinik, Im Neuenheimer Feld 410, D-69120 Heidelberg, GermanyBackground/Aims: In primary sclerosing cholangitis (PSC) dominant stenoses are frequently associated with bacterial, and in part, also fungal infections of the bile ducts. In the present study, the influence of dominant stenoses and of biliary infections on the long-term outcome was studied.Methods: In a prospective study, 171 patients were followed up for 20 years. All patients were treated with ursodeoxycholic acid. Dominant stenoses were treated endoscopically and during endoscopic procedures, bile was obtained for microbiologic

analysis.Results: Of 171 patients 97 had or developed major bile duct stenoses and 96/97 were treated endoscopically. In the 55/97 patients with dominant stenosis, bile samples were obtained and of these, 41/55 had bacteria, five had also Candida and 2/55 had only Candida in their bile. Survival free of liver transplantation in patients without dominant stenosis at 18 years was 73.1% and of patients with dominant stenosis was 25.0% (p=0.011). Bacteria in bile had no effect on survival whereas Candida in bile was associated with reduced survival (p=0.025).Conclusion: In patients with dominant stenosis, survival free of liver transplantation is reduced. Bacteria in bile do not worsen the outcome if dominant stenoses are opened endoscopically and infection is adequately treated with antibiotics. Candida in bile is associated with a poor prognosis and these patients need liver transplantation relatively soon.Abbreviations: ERCP,

endoscopic retrograde cholangio-pancreati cography, PSC, primary sclerosing cholangitisKeywords: Sclerosing cholangitis, Biliary disease, Cholestasis, Biliary infection, Liver disease, Endoscopic intervention, Ursodeoxycholic acid____________ _________ ____Dave (father of (23); PSC 07/03; UC 08/03)