Hypochlorhydria and Multiple Organ Failure: A Leading Cause of Death in the Intensive Care Unit

11 Abstract Various kinds of multiple organ failure (MOF) are briefly compared. We argue that many MOF’s result from those esophageal perforations due to oral Candida. We focus on a “silent” MOF associated with gastric hypochlorhydria and describe a prophylactic regimen that: (1) greatly reduces oral Candida and is predicted to stop their esophageal perforations; and (2) prevents Candidal colonization in the small intestine. The regimen uses: cetylpyridinium chloride (CPC) to decimate the oro-pharyngeal source of Candida; a slow release caprylic acid administered orally by intubation (or capsules) that antagonizes Candida colonization of the small intestine; and biotin to prevent conversion of Candida to the invasive hyphal form. We anticipate early use of the regimen should prevent all of the sequelae that result from esophageal perforation and from colonization of the duodenum and jejunum in patients and in non-patients who are using otc proton pump inhibitors ad lib to depress gastric acidity. Abbreviations: BSAC = British Society of Antimicrobial Chemotherapy; CanDPJ = Candida colonization of the duodenum and proximal jejunum; CMI = Cell Mediated Immunity; cvd = cardiovascular disease; CPC = cetylpyridinium chloride; Fn = Foundation; M&M = morbidity & mortality; otc = over the counter; PPI = proton pump inhibitors; Q10 = coenzyme Q10 (ubiquinone)