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IBS, migraine and chronic fatigue syndrome

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Professor Lovat
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Chronic Fatigue Syndrome and IBS

Irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS) are two conditions that can significantly impact one’s quality of life.

IBS is a condition of the gut that causes symptoms such as

  • Pain
  • constipation and/or diarrhoea
  • bloating

CFS causes

  • extreme, persistent tiredness that is not relieved by sleep.
  • muscle pain
  • headaches
  • joint pains

A number of different theories exist to explain the association between IBS and CFS

  • Post-infectious syndromes: Both CFS and IBS are known to arise in some people after infections. In 2004 the parasite Giardia infected the water supply in Bergen, Norway. In a three-year follow up of 770 people who had recovered from the infection, researchers found that 216 people had developed both IBS and CFS, 129 people had only developed IBS and 125 people had only developed CFS (the study can be found here).
  • Genetics: although there is no substantial evidence yet, researchers are investigating the theory that genetic variations increase the risk of developing IBS and CFS
  • Immune system: Some scientists have proposed that IBS can be caused by an immune response in the gut causing changes to bowel secretions, bowel contraction patterns and the way the bowel senses pain. Similarly, the immune system may be associated with CFS; if the immune system develops a fault, it may cause the production of substances that are linked to fatigue.

Migraine and IBS

A recent study has suggested that there may be a link between IBS and migraine.

It is well known among gastroenterologists that there is a strong link between the brain and IBS. IBS is characterised by increased hypothalamic activity resulting in increased stress responsiveness in the gut. Based on this, the researchers from Istanbul University wanted to explore if migraine and IBS are linked.

The study included 320 patients; 107 with migraine, 107 with IBS, 53 with episodic tension-type headache and 53 healthy patients. They found that of the patients with migraine, 58/107 also had IBS. They also found that of the patients with episodic tension-type headache, 30/53 had IBS. Of the patients with migraine, 38/107 had migraine and 24/107 had episodic tension type headache.

The researchers also found that there was an increased incidence of genetic abnormalities in the serotonin transporter gene among patients with IBS, migraine and episodic tension-type headache.

Based on these findings, it does seem that there may be a link between irritable bowels and migraines.

Erectile dysfunction and IBS

There are two types of erectile dysfunction: organic and psychogenic. Organic impotence describes the inability to maintain or obtain a firm erection. Psychogenic impotence, on the other hand, is caused by anxiety and other psychological triggers.

Although it has been known for a while that IBS is associated with an increased risk of organic impotence, a recent report has indicated the association between IBS and psychogenic impotence.

The study performed using data from Taiwan’s National Health Insurance Program demonstrated that there was a more than double incidence of organic impotence in patients with IBS compared to non-IBS patients. The study also found that the psychogenic impotence occurred almost three times more commonly in IBS than non-IBS patient groups.

These findings support the need for physicians to explore both organic and psychogenic causes of impotence in patients with IBS. The best treatment for organic impotence is life-style modification, such as diet. For psychogenic impotence, physicians should explore the co-existence of psychological diseases such as depression and anxiety.

Our private consultants at the London Gastroenterology Centre specialise in all sorts of bowel disorders as well as the tests to diagnose them. We offer endoscopy and colonoscopy in our central London hospital premises and have can bring a full range of supporting services to patients who need them such as dieticians and psychologists. Please phone our office on 020 7183 7965 to make an appointment. We would be delighted to help you.

 

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