Q:When I was about 18, I started to develop an itchy anus, a problem that has continued to the present day. I am now 26. In addition, for the last 5 years or so I have suffered from painful and itchy testicles, a problem which has fluctuated in sev

I have had several diagnoses and “cures” including being told that I had an anal fissure, generic rash and irritable bowel syndrome. I have used everything from talc to E45 cream to fungicides.

I have been a vegetarian since 1992 and I have, at times, suffered extremely painful bouts of constipation. Usually this has been after poor diet parties, drinking beer and eating snack foods.

I would appreciate it if you could put my problem to a member of your medical panel. Name supplied, Birmingham……..

A:We showed your letter to our panel member John Mansfield, who immediately recognized it as a potential case of candida infestation. Apart from the itching, the bouts of constipation, particularly after drinking beer (which is full of yeast) and eating snack foods (often shorthand for sugar) are indicative of this condition.

There is no specific test for candida. It tends to be diagnosed on patient history. If there is itching, constipation, wind and bloating, indigestion, bowel disturbances, a history of athlete’s, foot and/or other symptoms such as occasional clumsiness, candida is the likely culprit.

Dr Mansfield has noted in his own practice that a large number of patients with disorders as wide ranging as arthritis, IBS, asthma, chronic fatigue and Crohn’s disease will improve if given the anti fungal drug nystatin, and put on a yeast free, sugar free diet.

You will need to follow this special diet for six to eight weeks and continue taking the nystatin for three to four months (or berberis, for those who prefer a herb to a drug).

Eventually you should be able to follow a more varied diet but your sugar intake will always need to be kept very low.

Your problem may also be linked to leaky gut or low stomach acid. London based Biolab offers a gut fermentation test which can help pinpoint both of these problems. There is also a recent study which found that moistened toilet tissue containing Euxyl 400 can produce anal itching in 4 per cent of users (J Am Acad Derm, 1996; 35: 743-7).

Finally, you might wish to get hold of a copy of WDDTY’s Guide to Candida and ME (£4.95) or The Yeast Connection Handbook, by William G Crook (available from Professional Books, International Health Foundation, PO Box 3494, Jackson, Tennessee, 39301, USA; Price $14.95)

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Written by What Doctors Don't Tell You

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