The Fungal Etiology of Inflammatory Bowel Disease

The Fungal Etiology of Inflammatory Bowel Disease...

The Fungal Etiology of Inflammatory Bowel Disease

David A. Holland, M.D.

Crohn’s disease and ulcerative colitis, although distinguished by well-known characteristics, are collectively known as inflammatory bowel diseases (IBD). IBD is characterized by a host of symptoms such as diarrhea, abdominal cramps, rectal bleeding, weight loss, fever, and a host of extra-intestinal symptoms, including disorders of the eyes, liver, gallbladder, muscles and joints, kidneys, and skin.1 The treatments usually focus on relief of symptoms with anti-inflammatory drugs or surgery (i.e. removal of the affected part of the intestines).

The cause of IBD remains "unknown."

Some have implicated a viral etiology to IBD. In the medical journal The Lancet,2 Dr. Wakefield and colleagues found that three of four offspring in mothers that had measles during pregnancy developed severe Crohn’s later in life. Of note is that recurrent antibiotic-resistant pneumonia preceded the Crohn’s in every case.

This is important because antibiotics are known to increase the risk of fungal infection.3 Another study highlights this fact: an eight-year-old girl who was treated with antibiotics for recurrent upper respiratory tract infections developed intestinal candidiasis, an overgrowth of the yeast Candida albicans, in the gut.4

Other scientists have found carbohydrates to be a possible culprit. Two of three worldwide studies found the average intake of carbohydrates (including bread, potatoes, and refined sugars) to be much greater in those who developed IBD than in those who did not.4 Why would carbohydrates be implicated as a cause? Could it be that they are commonly contaminated with fungal toxins, according to a 2002 JAMA article and numerous agricultural publications, including the Council for Agricultural Science and Technology? 6, 7

In her book, "Breaking the Vicious Cycle," Elaine Gottschall describes the cycle of intestinal mucosal injury, impaired digestion, malabsorption, bacterial overgrowth, and increase in bacterial by-products and mucous production, which lead back to intestinal mucosal injury. We all know that antibiotics can alter the normal intestinal flora or bacteria. These bacteria usually keep in check the relatively small amount of existing yeast in the intestines.

However, when antibiotics are taken for various purposes–and you can bet those kids in Dr. Wakefield’s study were given plenty of antibiotics–the normal, protective bacteria are eliminated, and yeast growth goes unchecked. The resulting effects range from "mild diarrhea to severe colitis, or systemic fungal or bacterial dissemination."8 In Chapter 2 of our book, "The Fungus Link," you read about the link between arthritis and fungus.

When fungi become systemic from gut inflammation and the overuse of antibiotics, you can see how the whole body–again, the eyes, liver, gallbladder, muscles and joints, kidneys, and skin–becomes involved in inflammatory bowel disease.

Still other scientists have directly implicated yeast and fungal toxins, called mycotoxins, in the cause of Crohn’s disease. Former World Health Organization expert Dr. A.V. Costantini has found that people with Crohn’s often have aflatoxin, a mycotoxin made by Aspergillus molds, in their blood. Barclay found that disease activity in patients with Crohn’s was lower while they followed a yeast-free diet, specifically avoiding baker’s and brewer’s yeasts.9

Some feel that the yeast, Candida albicans, may be the cause of Celiac disease, also known as Sprue, or gluten-sensitive enteropathy.10 Celiac disease, doctors presume, is caused by a reaction to a protein particle called gluten that exists in certain grains.

This allergic-type reaction leads to inflammation and often severe symptoms in not only the intestines but also the entire body. Conventional treatment therefore involves suppressing the inflammation and symptoms with anti-inflammatory medications. It also requires the avoidance of these particular grains. Ironically, corn is a grain that does not contain gluten. It therefore falls in the "okay to eat" list offered by conventional practitioners and dieticians. Little do most practitioners know that corn is universally contaminated with mycotoxins.

So, over-consuming corn, as so many Celiac patients do since they have few other choices of grains in their diet, is likely to propagate the illness. Many people have successfully treated (dare we say cured?) their Celiac disease by not only avoiding grains altogether–especially corn–but also including antifungal medications in their treatment regimen. Such antifungals may include the natural, coconut-derived fatty acid known as Caprylic acid (available over the counter), or stronger, prescriptive antifungals. These stronger medicines might consist of a combination of nystatin (a broad spectrum gut antifungal) and either itraconazole (Sporanox®) or fluconazole (Diflucan®).

Chapter 13 of "Principles and Practice of Clinical Mycology" deals entirely with fungal infections in the gut. They describe how Blastomyces dermatitidis, a fungus, can produce "granulomatous" lesions in the intestines.

Not surprisingly, this same type of lesion has also been seen in patients with Crohn’s disease. Another fungus called Histoplasma produces intestinal disease with symptoms such as diarrhea, weight loss, fever, and abdominal pain–sound familiar? The common lesions seen in the gut with this infection were "masses or ulcers mimicking inflammatory bowel disease or carcinoma." The authors concluded that histoplasmosis should be a "serious consideration" in an immunocompromised patient with signs and symptoms of IBD.11

Back to the big word "immunocompromised," which means the immune system has been compromised, or weakened. We strongly disagree that you must have cancer or AIDS or be on chemotherapy to have a weakened immune system. Just smell the air on your way to work or look at our standard American diet (SAD), or even look at the number of antibiotics we consume from childhood on. Could these be impeding our immune systems? Most antibiotics are mycotoxins–fungal derivatives.

Mycotoxins are commonly found in our grain food supply. Mycotoxins can suppress our normal immune function. Therefore, anyone who has taken an antibiotic or consumes grains or sugar qualifies as a potentially immunocompromised person.

We’ve seen thus far that, in just about every case of inflammatory bowel disease, conventional treatment involves the use of anti-inflammatories. Well, researchers at the Washington University in St. Louis took a bold step and did a study where they offered patients with Crohn’s disease an immune stimulant instead.12 They used a medicine called Leukine–a naturally-occuring molecule called Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF).

And though they faced harsh criticism from scientists at other universities for doing this, they obtained amazing results: of the initial 15 patients in the study, 12 did "significantly" better overall, while eight went into complete remission! Every one of the half a million patients with Crohn’s disease in America should know about this study.

But they shouldn’t feel they need to rush in to their doctor’s office to get this expensive shot (it costs around $300 per milliliter–that’s $1,500 per teaspoon).

Rather, they should learn from this study: by giving an immune booster, these doctors were able to put 53 percent of the cases into total remission. That almost implies that an infection is at the root of the disease, and that by assisting the body’s immune system the medication helped the body overcome the "infection," or the disease.

Typically, an anti-inflammatory medicine merely controls the symptoms of the disease–it doesn’t cure it. That’s because it rarely addresses the true cause of the disease. In other words, if the wrong diet is constantly consumed, or if damage (i.e. yeast overgrowth) is never reversed from previous antibiotic use, a cure can almost never be achieved. In this case, we feel that the "infection" in the intestines of Crohn’s patients is caused by fungi and their mycotoxins.

Incidentally, you can boost your immune system much less expensively and without a prescription by taking beta-glucans (see or Using probiotics–Lactobacillus acidophilus, etc. (see–is also extremely vital in reversing antibiotic damage, since these good bacteria can keep yeast and fungi from re-establishing themselves in the intestines.

Anyone who has been diagnosed with ulcerative colitis or Crohn’s disease knows the misery these diseases can cause. Given the alternatives for treatment–more immune-suppressing drugs and surgery–we think it would be worth a trial on a program that includes a low-carb diet and antifungal medications or supplements. A 1944 Johns Hopkins Clinical Mycology book stressed the importance of following a low-carb diet while treating yeasts.13 If a fungus or mycotoxin is truly involved, all of these approaches will do more than just suppress the symptoms of or "manage" the disease–they can actually cure it.


  1. Journal of Musculoskeletal Medicine. Nov. 1996. Pp 28-34.
  2. Wakefield. The Lancet. 1996. 348:315-317.
  3. Baldwin, Richard S. The Fungus Fighters: Two Women Scientists and Their Discovery Cornell University Press. Ithaca and London. 1981.
  4. Ruiz-Sanchez, et al. Intestinal candidiasis. A clinical report and comments about this opportunistic pathogen. Mycopathologia. 2002;156(1):9-11.
  5. Heaton, K. W. Inflammatory Bowel Diseases. Allan, R.N., Keighley, M.R.B., Alexander-Williams, J., and Hawkins, C.F. [Eds.]. Churchill Livingstone, New York. 1990
  6. Etzel, R. Mycotoxins. Journal of the American Medical Association. 287(4). Jan 23/30, 2002.
  7. Council for Agricultural Science and Technology. Mycotoxins: Risks in Plant, Animal and Human Sytems. Economic and Health Risks. Task Force Report Number 139. Jan 2003. CAST. Ames, IA.
  8. Saadia, Roger and Lipman, Jeffrey. "Antibiotics and the gut". European Journal of Surgery. 1996. Suppl. 576:39-41.
  9. Barclay, G. R., et. al. (Scandinavian Journal of Gastroenterology. 1992. 27:196-200.
  10. Nieuwenhuizen, W., et al. Is Candida albicans a trigger in the onset of celiac disease? Lancet. 2003 June 21;361(9375):2152-2154.
  11. Kibbler, C. C., et. al [Ed.]. Principles and Practice of Clinical Mycology 1996. John Wiley & Sons, Ltd., West Sussex, England
  12. Hesman, T. WU Researchers have developed controversial Crohn’s treatment. St. Louis Post-Dispatch. Nov 8, 2002.
  13. Conant, et al. Manual of Clinical Mycology. WB Saunders, Philadelphia. 1944.

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