Predictors Of New Onsets Of Irritable Bowel Syndrome Chronic Fatigue Syndrome And Fibromyalgia: The Lifelines Study
Abstract:
Background: It has been claimed that functional somatic syndromes share a common etiology. This prospective population-based study assessed whether the same variables predict new onsets of irritable bowel syndrome , chronic fatigue syndrome and fibromyalgia .
Methods: The study included 152 180 adults in the Dutch Lifelines study who reported the presence/absence of relevant syndromes at baseline and follow-up. They were screened at baseline for physical and psychological disorders, socio-demographic, psycho-social and behavioral variables. At follow-up new onsets of each syndrome were identified by self-report. We performed separate analyses for the three syndromes including participants free of the relevant syndrome or its key symptom at baseline. LASSO logistic regressions were applied to identify which of the 102 baseline variables predicted new onsets of each syndrome.
Results: There were 1595 , 296 and 692 new onsets of IBS, CFS, and FM, respectively. LASSO logistic regression selected 26, 7 and 19 predictors for IBS, CFS and FM, respectively. Four predictors were shared by all three syndromes, four predicted IBS and FM and two predicted IBS and CFS but 28 predictors were specific to a single syndrome. CFS was more distinct from IBS and FM, which predicted each other.
How To Tell You Have Chronic Lyme Disease
First, you should know 50 percent of people with chronic Lyme do not remember a tick bite. And at least 30 percent of people do not remember the classic bullseye rash. So it is very important to get proper testing.
But testing is extremely complicated. The standard way most physicians test for Lyme is to perform a two-step test method involving an elisa test. If the elisa is positive, then another test called a western blot is performed to determine if the elisa is correct. But here is the problem, studies show that nearly 50 percent of elisa testing will miss Lyme disease when someone has it.
In my practice, I use a test by IGenex called the Immunoblot. This test looks to see if a person has antibodies against eight kinds of Lyme bacteria. According to IGenex validation studies, this method can find Lyme when it is present 95 percent of the time. For more information about Lyme testing and this specific method read A Review of Lyme Infection Tests: Pass or Fail.
Making a diagnosis of Lyme disease is complicated. It is possible to diagnose Lyme disease, even when testing is negative. For more information about how to diagnose Lyme disease especially when testing is negative see How to Diagnose Chronic Lyme Disease, More Than A Test.
Both Conditions Mainly Affect Women
The similarities are:
- Low growth hormone
- Familial aggregation/haplotypes
Both conditions mainly affect women, and they differ in the amount of pain and fatigue. The same medications, however, are used in both cases.
If you look at the conditions scientifically, things get even more confusing, but science proves that the two conditions are entirely different.
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Other Risk Factors For Fibromyalgia And Chronic Fatigue Syndrome
There are other risk factors for Fibromyalgia and Chronic Fatigue Syndrome. Women are more likely to be afflicted by them than men. You can be genetically predisposed as well if you have a familial history. Studies have also shown that people who have osteoarthritis, rheumatoid arthritis, and lupus are also more likely to have Fibromyalgia. Chronic stress is also a trigger.
Prevalence Of Cfs And Fm
In 2010, about 411 000 and 444 000 of Canadians aged 12 years and older reported having been diagnosed with CFS and FM, respectively. About 0.3% of the total household population reported having both conditions. Approximately 1 in 4 people with CFS also reported having FM, and 1 in 5 people with FM also reported having CFS. Overall, the prevalence of CFS and/or FM was higher in women across all age groups .
Prevalence of chronic fatigue syndrome, fibromyalgia and both conditions by age and sex, Canadians 12 years and older, 2010 Canadian Community Health Survey
Abbreviations: CFS, chronic fatigue syndrome FM, fibromyalgia.
Note: Prevalence estimates for males with FM only aged 1244 and for males with comorbid FM and CFS aged 1244 and 65+ are not shown due to high sampling variability.
E Interpret with caution coefficient of variation between 16.6% and 33.3%.
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Severity Of Chronic Fatigue Syndrome Symptoms
Symptoms vary widely in severity and people may have some symptoms more severely than others. However, the following definitions are provided by NICE to provide a guide to the level of impact of symptoms on everyday functioning:
Features of mild chronic fatigue syndromeThese include:
- You are able to care for yourself and do some light domestic tasks but may have difficulties with mobility.
- You are usually still able to work or attend education, but to do this you have probably stopped all leisure and social pursuits.
- You often have reduced hours, take days off and use the weekend to cope with the rest of the week.
Features of moderate chronic fatigue syndromeThese include:
- You have reduced mobility and are restricted in all activities of daily living.
- However you may have peaks and troughs in your level of symptoms and ability to do activities.
- You have usually stopped work or education, and need rest periods, often resting in the afternoon for one or two hours.
- Your sleep at night is generally of poor quality and disturbed.
Features of severe chronic fatigue syndromeThese include:
- You are unable to do any activity for yourself, or you can carry out minimal daily tasks only .
- You have severe cognitive difficulties and may depend on a wheelchair for mobility.
- You are often unable to leave the house or you have a severe and prolonged after-effect if you do so.
- You may also spend most of your time in bed and are often extremely sensitive to light and sound.
Fibromyalgia Chronic Fatigue And Chronic Fatigue Syndrome
Editors Note: This article is excerpted from Dr. Goldenbergs new book, Chronic Widespread Pain: Lessons Learned from Fibromyalgia and Related Disorders. To purchase the entire e-book, go to ppmjournal.com/fibro and use the promo code READPPM for a 15% discount.
Persistent exhaustion is almost always present in patients with fibromyalgia and is prominent in each of the overlapping chronic functional illnesses, including irritable bowel syndrome , chronic migraine, and chronic bladder and pelvic pain. Unfortunately, there is no universal definition of what constitutes pathologic fatigue. The most common description of excess fatigue suggests that it is an extreme and persistent form of mental and/or physical tiredness, weakness, or exhaustion.
Chronic fatigue, like chronic pain, is a common symptom in the general population, with prevalence estimates between 10% and 40%.
Chronic fatigue, like chronic pain, is a common symptom in the general population, with prevalence estimates between 10% and 40%. In 1 study, nearly 20% of 31,000 men and women in a general practice reported substantial fatigue lasting 6 months or longer.2 During the past decade, most studies have defined chronic fatigue as fatigue lasting 6 months or longer with fatigue scores of 8 or greater on the Fatigue Scale.3 Women are more likely to report fatigue and more often report severe fatigue.2-4 The prevalence of fatigue was 30% in older women compared with 15% in older men.5
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Fibromyalgia And Chronic Fatigue Syndrome Are So Similar That They Are Often Confused With Each Other
Symptoms defined as debilitating fatigue, post-exertion malaise, sore throat, headache, joint aches and general weakness, swelling, and numbness, plus memory loss and depression, are a part of both conditions.
Both conditions share reduced cortical and midbrain blood flow. Neurotransmitters that send pain messages to the brain cause the debilitating pain in fibromyalgia, but not in CFS. A cellular antiviral enzyme is often elevated in CFS and causes pain. These are significant differences between the two conditions. In fibromyalgia, pain is caused by neurotransmitters, and in CFS pain is caused by antiviral enzymes.
Chronic fatigue syndrome is triggered by the flu, infectious illnesses, or maybe a trauma or surgery. Fibromyalgia is caused by trauma and rarely by an infection.
Treatment is usually just symptomatic therapy and supportive care. A good diet, supplements, management of sleep disorders and pain are the necessary treatments. Both fibromyalgia and chronic fatigue syndrome are treated with the same medications.
Often counseling is used as a coping mechanism for the stress and pain of both conditions, and with stress and pain, studies claim that low-level exercise is beneficial. If you choose to exercise with either syndrome, however, do pace yourself and stop when you are fatigued or sore.
How Is Fibromyalgia Diagnosed
The persons symptoms are considered during the tests and diagnosis for fibromyalgia. Symptoms such as widespread pain affecting the joints and muscles, in combination with sleeping difficulty and fatigue, would require tests for the condition. A thorough physical examination will be conducted by a medical professional in order to exclude any other illnesses that may manifest similar symptoms.
There are no widely accepted diagnostic criteria for fibromyalgia yet. Hence, any testing carried out is only done to exclude the possibility of other health conditions.
For instance, your doctor may want to exclude the possibility of conditions such as rheumatoid arthritis, sleep apnea, lupus, and multiple sclerosis. Although this may not make sense to you, fibromyalgia is known to mimic other medical conditions.
In most cases, the fibromyalgia tender points feel tender upon palpation. However, some patients are not tender at these soft tissue regions . Generally, it is more likely that females would be tender at the fibromyalgia tender points than their male counterparts.
Aside from the presence of tender points, a doctor with knowledge about fibromyalgia will consider the history of widespread pain. If the pain is present below and above the waist and at the left and right sides of the body, the doctor will now consider the duration of pain. Chronic pain lasting more than three months is an indicator of the presence of fibromyalgia.
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What Can Be Done
If you think you may be struggling with chronic fatigue, it is important to discuss your symptoms with your healthcare provider. Symptoms that are particularly important to discuss include:
- anxiety
- pain
- tired
It is also important to tell your healthcare provider about the medications you are taking, including dietary supplements, natural remedies, and complementary treatments. Some medications can exaggerate the symptoms listed above. For example, stimulants , as well as corticosteroids, may cause sleep disturbances. Your healthcare provider can provide guidance on what medications and interventions may restore your sleep, as well as advice on medications to avoid.
It is also important to discuss chronic pain symptoms with your healthcare provider because chronic pain often leads to sleep difficulties, which in turn leads to chronic fatigue. Your healthcare provider may order laboratory tests to determine if organ involvement may be causing chronic fatigue.
For those with arthritis, maintaining a healthy weight and participating in regular exercise may also help reduce symptoms of chronic fatigue.
Disease Semantics And Naming
Chronic fatigue syndrome and fibromyalgia are diagnosed when no other cause of fatigue or muscle achiness can be found. They are both a diagnosis of exclusion. This means we exclude any other causes of these problems.
If someone actually has Lyme disease causing muscle pains or fatigue, then it is no longer correct to say they have fibromyalgia or chronic fatigue syndrome. They actually have Lyme disease causing muscle aches or severe fatigue and all the other symptoms associated with these two diagnoses.
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Suppression Of The Hypothalamus Gland
The hypothalamus gland controls most other glands in the body including the adrenals, the thyroid, and the sex hormones. It also controls the autonomic nervous system and sleep. Because the hypothalamus is suppressed, we often find imbalances with other hormones as well. When the hypothalamus is weakened, it causes a cascade of negative effects that can occur in your body. The weakness of the gland happens because of long-term stress, acute trauma or stress, chronically deficient diet, exposure to toxins, as well as a number of other factors.
Overlapping Symptoms: Fatigue Mood Pain
It is not clear that this updated definition for CFS will advance the understanding of the disorder or its acceptance as a diagnosable condition.22,25 There was little evidence that the new case definition was an improvement over prior CFS case definitions given continued diagnostic uncertainty.28 The new diagnostic criteria do not offer clinicians the ability to distinguish CFS from overlapping functional somatic syndromes, and in particular FM.
Most studies have found a significant clinical overlap of FM and CFS symptoms, with the majority of individuals meeting criteria for both syndromes.29,30 In 1 report, 50 patients with primary FM who had been followed in an academic rheumatology practice frequently reported symptoms thought to be typical of chronic Epstein-Barr virus infection , but not of FM. These included recurrent sore throat , recurrent rash , chronic cough , recurrent adenopathy , and recurrent low-grade fevers .29 In 55% of the patients, the illness had begun suddenly, with what seemed to be a viral syndrome.30 However, antibody titers to Epstein-Barr virus in the patients were not significantly different from those in age- and sex-matched healthy and unhealthy control subjects.30 This overlap is not surprising since fatigue is the second most prominent symptom in FM, right after chronic widespread pain.
Pain Catastrophizing
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Circulating Leptin Levels In Patients With Myalgic Encephalomyelitis Chronic Fatigue Syndrome Or Fibromyalgia: A Systematic Review Protocol
Abstract:
Objective: The objective of the review is to evaluate circulating levels of leptin in people diagnosed with myalgic encephalomyelitis chronic fatigue syndrome or fibromyalgia syndrome and to investigate the differences compared with healthy controls.
Introduction: Myalgic encephalomyelitis chronic fatigue syndrome is a condition that has major symptoms, including self-reported fatigue, post-exertional malaise, and unexplained pain across the body. The widespread pain is measured in a systematic way and is often referred to as fibromyalgia. The two disorders have many similarities, but their association with leptin has indicated that leptin may affect the role of pro-inflammatory cytokines and symptom severity.
Inclusion criteria: This review will consider observational studies of varying study designs including prospective and retrospective cohort studies, case-control studies, time-series, and analytical cross-sectional studies that include both cases and healthy comparators. Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants. Only studies published in English will be included due to limited resources for translation.
Is There A Connection Between Fibromyalgia And Chronic Fatigue Syndrome
Fibromyalgia and chronic fatigue syndrome can both be chronic and long term medical conditions and they are both characterized by extreme levels of fatigue. In fact, both medical conditions are interwoven to the extent that it has sparked a series of opinions and differences among medical experts. Some in the medical community wonder whether CFS and fibromyalgia fatigue are two similar disorders with different forms of expression.
Clinical scientists have discovered that both conditions are common among middle-aged people. It also appears that both conditions affect more women than men. About 80-90 percent of those with fibromyalgia are females, while chronic fatigue syndrome is four times more likely to affect females than males.
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Confirming A Relationship Between Cfs/me And Fm
SEM results confirmed that both groups were invariant on all the questionnaires with the exception of the American CDC Symptom Inventory, the FIQ and the HADS . The results also confirmed that the criteria for metric invariance have not been fulfilled, suggesting that CFS/ME and FM groups were responding differently to items on these questionnaires for each model. To identify which questions were responsible, each item was constrained individually. The results confirmed that, on the CDC Symptom Inventory, muscle aches and pains was the item of interest ). Two items on the FIQ were identified: the symptoms ) and how tired have you been ). On the HADS, the questions identified were: I can laugh and see the funny side of things ) and I can enjoy a good book or radio programme ).
The Syndrome Model and note changes made. C=CFS/ME, F=FM. CDC, Centers for Disease Control and Prevention err, errors FIQ, Fibromyalgia Impact Questionnaire Anxiety and Depression = HADS, Hospital Anxiety and Depression Scale.
Fibromyalgia And Chronic Fatigue Syndrome May Look Like The Same Condition But They Both Have Noticeable Differences
Fibromyalgia and chronic fatigue syndrome are strikingly similar, and medical experts have a difficult time telling them apart.
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One opinion in the fibromyalgia/CFS debate claims that fibromyalgia and CFS are the same disorder with different personalities, others claim the conditions are entirely different, and still others believe that neither syndrome exists at all.
If you go to your primary care doctor and give them a list of your complaints fatigue, trouble with memory, and vague aching in your muscles and joints, your primary care doctor will probably diagnose you with chronic fatigue syndrome. Why? Many doctors still use the 1994 international case definition for CFS, which was published by the Centers for Disease Control.
On the other hand, if your primary complaint is constant pain, and you consult a rheumatologist, you will be diagnosed with fibromyalgia based on tender points that are defined by the American College of Rheumatology .
Both syndromes have overlapping disorders like irritable bowel syndrome, urinary incontinence, mitral valve prolapse, and temporomandibular dysfunction. You may also experience migraines, restless legs, myofascial pain syndrome, chemical sensitivities, and maybe hyperextensibility, acne rosacea, dry eyes and mouth and a constant runny nose with congestion.
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