When speaking about urinary tract infections, we usually speak about bacterial infections. Fungi (a.k.a yeasts or mold) are different organisms from bacteria and they can cause infections such as thrush in some parts of the body. Fungal infections in the vagina for example are a well-known condition. But can there also be fungal infections in the urinary tract?
In recent years, new research has established that the urinary bladder is not sterile as it was previously believed.
In fact, it is home to communities of microorganisms that, in the right balance, help to keep the bladder healthy.
Changes in the balance of these microorganisms have been noted to be present in all bladder conditions.
Further, it has been shown that standard testing does not pick up all infections reliably. So if you experience symptoms after a negative test result it does not necessarily mean that no infection is present.
Standard testing also does not test for organisms other than bacteria. But are they even a thing?
Fungal Infections in the Body
Most people will have heard of thrush before. It is an infections caused by the fungus Candida Albicans that can occur in the vagina, on the penis or in the mouth.
Athlete’s foot is another common fungal infection affecting the feet. These fungal infections are well accepted by the medical establishment [1,2] and usually treated with anti-fungal medication.
In the alternative health world, Candida infections have been a buzzword for many years. Candida is what I came across when I first started looking at possible root causes for my bladder pain and IBS.
However, when I unknowingly asked my doctor about Candida infections in the gut, she just told me she ‘doesn’t believe in it’ and sent me home. This was not the only time I heard a doctor say this line.
It is perhaps a bit naïve to blame all infections on Candida, as I frequently came across when I started researching my problems in a more ‘natural health’ context.
But fact is, that the literature contains many papers that talk about gastrointestinal and systemic (whole body) fungal infections [e.g. 3, 4, 5, 6]. Although some of these studies are rather old, they should not be disregarded.
A new study even stated that ‘[Candida] can also become invasive, causing life-threatening systemic and bloodstream infections in immunocompromised hosts, where the mortality rate can be as high as 50 %’ .
So much to ‘not believing in it’.
The problem perhaps is, that everything is blamed on Candida when it could well be another fungal strain (such as Saccharomyces or Aspergillus), a different kind of infection or something completely different – symptom are often non-specific and similar.
Luckily we can test the gut now. Stool or antigen tests can show what’s going on. Better even, new metagenomics tests can show us bacteria and fungi (e.g. mapmygut).
Fungal Infections of the Urinary Tract
As you’ve hopefully seen above, systemic fungal infections are a thing – whether your doctor believes in them or not.
Therefore, it makes sense that fungal infections could also affect the urinary tract.
And in fact, recent studies have shown that this is the case.
A study from 2016 used a novel, culture-independent testing method which showed that females with interstitial cystitis/Painful Bladder Syndrome flares showed a greater prevalence of certain fungi, specifically Candida and Saccharomyces species .
An even newer study showed that specific microbial patterns correlated with specific urinary tract symptoms. Overall, they actually found a decreased diversity of fungal species in patients with more severe symptoms. Bladder pain patients had altered levels of Malassezia spp while patients with incontinence had changes in Wickerhamomyces spp .
The Problem with Testing and Treatment
Current gold standard testing misses a lot of bacterial infections as is but in the case of fungal infections, it doesn’t pick them up at all and other testing methods are needed.
This means that if you have symptoms but no infection has been found it does not guarantee that there isn’t a fungal infection present.
Antibiotic treatment also poses a problem as fungi are not affected by antibiotic treatment. Instead, bacterial species that may keep fungi in check from taking over, may be killed off by antibiotics allowing fungi to proliferate.
Instead, anti-fungal medication is needed but with the lack of adequate testing, doctors are unlikely to prescribe them as there would be no ‘proof’ of an infection.
This shows once again, that the balance of the microbial system is really important.
What to do if you suspect a Fungal Infection
Unfortunately, adequate testing is not yet widely available. If you’ve had a stool test that indicates fungal infections this may indicate other fungal infections in the body. But we can’t know for sure.
An open-minded doctor may be up for trying anti-fungal medication if other therapies have not worked.
Several natural compounds have both antibacterial and antifungal activity and may be worth trying – however, don’t assume that something is safe only because it is natural. Do your research!
What this shows more than anything is that we need better testing!
Testing is outdated and misses infections with people wrongly being diagnosed with ‘incurable’ IC.
What can we do about it? Speak up, join patient advocate groups such as CUTIC that are campaigning for better testing.
Now I’d like to hear from you: Have you had fungal infections in the past? Do you think your bladder symptoms could be connected to fungi? Let me know in the comments.
Pin it for later:
- NHS Choices Vaginal Thrush March 2016 http://www.nhs.uk/Conditions/Thrush/Pages/Introduction.aspx
- NHS Choices Athlete’s Foot September 2015 http://www.nhs.uk/Conditions/Athletes-foot/Pages/Introduction.aspx
- William R. Jarvis Epidemiology of Nosocomial Fungal Infections, with Emphasis on Candida Species Clinical Infectious Diseases, Volume 20, Issue 6, 1 June 1995, Pages 1526–1530 https://academic.oup.com/cid/article-abstract/20/6/1526/477408
- Leslie S.Wilson et al The Direct Cost and Incidence of Systemic Fungal Infections Value in Health Volume 5, Issue 1, January–February 2002, Pages 26-34 http://www.sciencedirect.com/science/article/pii/S1098301510600058
- ERAS, PHILIP et al CANDIDA INFECTION OF THE GASTROINTESTINAL TRACT. Medicine: September 1972 – Volume 51 – Issue 5 – ppg 367-380 http://journals.lww.com/md-journal/citation/1972/09000/candida_infection_of_the_gastrointestinal_tract.2.aspx
- R J Prescott et al Fungal infections of the small and large intestine. J Clin Pathology Volume 45, Issue 9 http://jcp.bmj.com/content/45/9/806
- Neil A. R. Gow et al Microbe Profile: Candida albicans: a shape-changing, opportunistic pathogenic fungus of humans 15 August 2017, Microbiology 163: 1145-114 http://mic.microbiologyresearch.org/content/journal/micro/10.1099/mic.0.000499
- Curtis Nickel et al Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study J Urol. 2016 Feb; 195(2): 356–362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770794/
- Ackerman, A. LenoreResearch Network, MAPP et al. MP29-10 ALTERATIONS IN THE URINARY FUNGAL MYCOBIOME IN PATIENTS WITH BLADDER PAIN AND URINARY URGENCY The Journal of Urology , Volume 197 , Issue 4 , e383 – e384 http://www.jurology.com/article/S0022-5347(17)31146-1/fulltext