Candida is a yeast – the same sort of organism that we use to brew beer and make bread, although only a distant relative of these domesticated microbes. Yeasts are microscopic fungi – tiny cousins of the moulds and mushrooms. Most fungi grow as long thin threads called hyphae – they are so slender that they can only be seen under a microscope, but a mass of intertwined hyphae is visible: this is what makes up toadstools and mushrooms. Yeasts are different from other fungi, in that they do not usually form hyphae, but exist as tiny egg-shaped cells. However, some yeasts can grow in both ways – either as hyphae or as single cells. Candida is one of the yeasts that has this versatile approach to life, and the relevance of this will become clear later.

All of us have some Candida yeasts in our gut. They are a normal part of the gut flora – the millions of bacteria and other microbes living in our digestive tract, mostly in the large intestine. These feed on the remains of our meals but do us no harm – in fact they are essential to the well-being of the gut.

In the normal, healthy person the gut flora is a balanced community of different organisms. But under certain circumstances, the gut flora can become disturbed, and then one microbe may be overrepresented, while another is

rarer than it should be. The most common cause of this is taking antibiotics by mouth, because these can kill off the ‘good’ bacteria in the gut, allowing not-so-good microbes to multiply and replace them. Most antibiotics are bacteria-killers, and because a fungus is a very different sort of beast, these antibacterial drugs do not kill off yeasts. So any course of antibiotics is likely to benefit the yeasts in the gut at the expense of the bacteria.

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