Chronic Fatigue Syndrome & The Connection To IBS

If you regularly experience unexplained tiredness and fatigue that does not improve with rest, amongst other symptoms, you may be suffering from chronic fatigue syndrome (CFS).

This complex condition can be a little difficult to diagnose, as its main symptoms can be caused by many other underlying medical conditions, such as infections or psychological disorders.

It’s also typically very challenging to treat; it’s usually a managed condition, with the aim of improving quality of life and reducing the severity of the fatigue and other symptoms.

However, some recent findings may shed some more light on this puzzling and troubling condition.

Symptoms and causes of CFS

You may hear CFS referred to as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME).

The main symptoms include:

Fatigue

Feelings of exhaustion after physical or mental exercise

Poor memory or concentration

Muscle or joint pain

Sore throat

Enlarged lymph nodes in neck/armpits

Headaches

Poor quality sleep

Central nervous system disturbances

Possible depression

Digestive problems

The causes of CFS are not known but various theories include viral infections, immune system problems, hormonal imbalances, pre-illness stress, and other varied combinations of factors. None of these suggested causes have been proven, though.

Women in their 40s or 50s are most likely to suffer from CFS, though it can affect almost anyone.

The connection with digestive problems

Of the symptoms of chronic fatigue syndrome listed above, digestive disturbances are perhaps one of the least focused on.

Yet many CFS patients do complain of gastrointestinal problems; they are also more likely to experience irritable bowel syndrome (IBS)-related symptoms; and one extensive study found that over 70 percent of patients with CFS met the standard criteria for IBS.

There are also some other interesting correlations that may lead to new approaches for treating CFS.

For instance, research from the early 00s has indicated that CFS patients experience significant intestinal microflora anomalies compared to healthy patients; in particular, lowered levels of bifidobacteria and small intestinal bacterial overgrowth (SIBO).

Another study published in 2003 suggested that lactic acid bacteria may assist in the treatment of chronic fatigue syndrome; yet this appears to have received little attention until more recently.

The authors of that study observe that people with CFS “are under increased oxidative stress, have a type 2 helper cell dominate cytokine profile, frequently report allergies, have altered essential fatty acid (EFA) status and may have malabsorption of certain micronutrients.”

They attest in the study that:

“Lactic acid bacteria (LAB) have the potential to influence the immune system in CFS patients by supporting T helper cell 1 driven cellular immunity and may decrease allergies. In addition, LAB are strong antioxidants, may improve EFA status, can enhance absorption of micronutrients by protecting the intestinal epithelial barrier, and have been used to treat SIBO.”

Furthermore, they conclude that “LAB may have a therapeutic role in the treatment of CFS.”

A new approach to fighting CFS?

Could this open a new ‘front’ in treating patients with CFS? Certainly these findings warrant more investigation and the connection between IBS and CFS has started to garner more attention in recent years.

For instance, scientists at Columbia University's Mailman School of Public Health recently ran a study that assessed imbalances in the gut bacteria in individuals with CFS, some of whom also had IBS.

The study was published in the journal Microbiome and found abnormal levels of specific gut bacteria related to chronic fatigue syndrome in patients with IBS.

Followers of my articles will not be surprised to learn that the health of the gut is closely connected to many more aspects of health than purely good digestion.

Just how closely it is related to CFS requires further study but indications suggest that it’s worth pursuing.

Resources

Alan C. Logan, A. Venket Rao, Dinaz Irani. Chronic fatigue syndrome: lactic acid bacteria may be of therapeutic value. Medical Hypotheses (2003) 60(6), 915–923.

Komaroff A. L., Buchwald D. Symptoms and signs of chronic fatigue syndrome. Rev Infect Dis 1991;

13(suppl. 1): S8–11.

Komaroff A. L., Fagioli L. R., Geiger A. M. et al. An examination of the working case definition of chronic

fatigue syndrome. Am J Med 1996; 100: 56–64.

Aaron L. A., Burke M. M., Buchwald D. Overlapping conditions among patients with chronic fatigue 

syndrome, fibromyalgia and temporomandibular disorder. Arch Int Med 2000; 160: 221–227.

Butt H. et al. Faecal microbial growth inhibition in chronic fatigue/pain patients. Proceedings of the AHMF International Clinical and Scientific Conference; 1998 Feb 12–14; Sydney, Australia.

Butt H. et al. Bacterial colonosis in patients with persistent fatigue. Proceedings of the AHMF International Clinical and Scientific Conference; 2001 Dec 1–2; Sydney, Australia.

Columbia University's Mailman School of Public Health. Chronic fatigue syndrome linked to imbalanced microbiome: Scientists identify abnormal levels of specific gut bacteria in individuals with chronic fatigue syndrome, including those with and without co-morbid IBS. ScienceDaily, 26 April 2017.