Dr. Lieberman: In our practice, we’ve always used a rather classical approach with systemic anti-fungal drugs and local-acting fungal drugs, often combined. With this approach we can treat the reservoir of yeast in the gut with the local-acting fungal drugs, but also treat elsewhere in the body where yeast may have been able to migrate due to a permeable gut or impaired immune system that didn’t keep the yeast localized. It depends upon the patient as to how long the treatment has to be applied. For example, interestingly, many cases of chronic prostatitis in males are actually yeast prostatitis, and that’s the reason why they never get rid of the problem because they’re treated with more and more antibiotics. It’s often a combination infection of both yeast and bacteria, and until you identify which organisms are causing the infection and treat them appropriately for a sufficiently long time, the problem doesn’t resolve. We have not found cultures and stool analyses and other diagnostic tests to be entirely accurate, but with the aid of the other newer tests we use like Shaw’s test, we have very good results with many different kinds of chronic problems.