Gastrointestinal system

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The gastrointestinal system is an organ system which takes in food, digests it to extract and absorb energy and nutrients, and expels the remaining waste as feces. It consists of the esophagus, stomach, and intestines, and is divided into the upper and lower gastrointestinal tracts.

Autonomic nervous system dysfunction of the gut, dysmotility, dysbiosis, and potentially, gut pathogens, are all thought to contribute to the symptoms of ME.

Evidence of gastrointestinal dysfunction in CFS[edit | edit source]

Dysbiosis[edit | edit source]

There is strong evidence that dysbiosis or an imbalance in the microbial ecology of the gut plays a role in the symptoms of ME/CFS. On average, ME/CFS patients have lower levels of Bifidobacteria, Escherichia coli and higher levels of aerobic bacteria,[1] in particular Enterococcus and Streptococcus species.[2] The latter produce D-lactate, a form of lactic acid only produced by non-human cells that is poorly metabolized in humans. D lactate is associated with a wide variety of cognitive and neurological symptoms, such as in patients who suffer from D-lactic acidosis. A study found that higher levels of enterococcus bacteria in CFS patients were associated with more severe neurological and cognitive dysfunction.[3]

CFS patients may suffer from small intestinal bacterial overgrowth (SIBO) at high rates.[citation needed]

One hypothesized consequence of dysobiosis is an overproduction of hydrogen sulfide (H2S) by pathogenic bacteria. H2S can inhibit mitochondrial respiration by blocking cytochrome c oxidase.[citation needed]

A study of Norwegian and Belgian patients found significantly decreased proportions of Firmicutes genera Holdemania and increased proportions of Bacteroidetes genera Alistipes in the Norwegian but not the Belgian sample. Significantly increased proportions of Firmicutes genera Lactonifactor were found in both.[4]

Intestinal permeability[edit | edit source]

In a healthy digestive tract, the intestinal walls provide a tight, selective barrier to allow the absorption of nutrients prevent the entry of bacteria or pathogens. However, in CFS patients, there is evidence of increased intestinal permeability or "leaky gut." Intestinal permeability can allow for the translocation of bacteria across the mucosal lining and inside the blood stream.

One study found higher levels of serum IgA and IgM against lipopolysaccharides (LPS), a major component of the outer membrane of gram-negative bacteria, indicating translocation.[5] Serum IgA was significantly correlated to the severity of illness.

Malabsorption[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

serum - the clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation

serum - the clear yellowish fluid that remains from blood plasma after clotting factors have been removed by clot formation

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.