Diagnostic criteria for chronic candida research

An unambiguous definition

Before any study of chronic candida (aka Candida-Related complex, CRC) can be done, an unambiguous definition¹ is required. Some books about this phenomenon list so many symptoms as diagnostic of the disorder that the end up with an overly broad definition of what defines the disorder. Restrictive, limited diagnostic criteria are necessary for research purposes. There must be a gold standard that definitively distinguished chronic candida from other, similar conditions.

I have been using the criteria below. They are based on my contact with other patients, and accounts written by practitioners. I don't believe they encompasses all cases of chronic candida. However, most advocates for the existence of the condition would agree that a patient meeting these criteria definitely has the disorder.

1. Presence of two or more gastrointestinal(GI) symptoms of sufficient severity to cause a change in diet or take medication, lasting more that two months and not responding completely to appropriate treatment.
• Constipation, diarrhea, or obstipation
• Bloating
• Indigestion/sour stomach
• Food sensitivities
• Regurgitation
• Heartburn/esophagitis
2. Presence of fatigue and difficulty concentrating("brain fog"), severe enough to substantially reduce or impair normal functioning.
3. Use of antibiotics for a cumulative total of greater than two months of daily use, with some use falling immediately prior to the development of symptoms.
4. Absence of any known general medical disorder that would sufficiently account for these symptoms, such as:
   • CFIDS
   • Crohn's disease
   • Celiac sprue
   • Giardia
   • Small bowel bacterial overgrowth
   • Hypothyroidism
   • Hypoadrenalism(Addison's disease)
5. A significant, lasting positive response to both of the following treatments.
   • One or more prescription antifungal (i.e. nystatin, diflucan, lamisil, sporanox).
   • The dietary elimination of sugar(candy, cake, ice cream) and highly refined carbohydrates(potato chips and other high-calorie snack foods with hydrogenated fat).

References

1. Bennet JE MD "Searching for the yeast connection" New England Journal of Medicine 323(25):1766-7, Dec. 20 1990

This page last modified 2023-04-28