title: Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.
abstract: BACKGROUND
  There is evidence that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by gastro-intestinal symptoms; and IgA and IgM responses directed against lipopolysaccharides (LPS) of commensal bacteria, indicating bacterial translocation.
  
  
  METHODS
  This study was carried out to examine gastro-intestinal symptoms in subjects with ME/CFS versus those with chronic fatigue (CF). The two groups were dissected by dichotomizing those fulfilling and not fulfilling Fukuda's critera. In these groups, we examined the association between gastro-intestinal symptoms and the IgA and IgM responses directed against commensal bacteria.
  
  
  RESULTS
  Using cluster analysis performed on gastro-intestinal symptoms we delineated that the cluster analysis-generated diagnosis of abdominal discomfort syndrome (ADS) was significantly higher in subjects with ME/CFS (59.6%) than in those with CF (17.7%). The diagnosis of ADS was strongly associated with the diagnosis of irritable bowel syndrome (IBS). There is evidence that ME/CFS consists of two subgroups, i.e. ME/CFS with and without ADS. Factor analysis showed four factors, i.e. 1) inflammation-hyperalgesia; 2) fatigue-malaise; 3) gastro-intestinal symptoms/ADS; and 4) neurocognitive symptoms. The IgA and IgM responses to LPS of commensal bacteria were significantly higher in ME/CFS patients with ADS than in those without ADS.
  
  
  CONCLUSIONS
  The findings show that ADS is a characteristic of a subset of patients with ME/CFS and that increased bacterial translocation (leaky gut) is associated with ADS symptoms. This study has defined a pathway phenotype, i.e bacterial translocation, that is related to ME/CFS and ADS/IBS and that may drive systemic inflammatory processes.
authors.affiliation: Maes Clinics @ TRIA, Bangkok, Thailand, Thailand.
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
authors.affiliation: Laboratory Ategis, Wavre, Belgium.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Leunis
authors.affiliation: Association Institute for Research and Development in Human Pathology and Therapy, Talence, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Geffard
authors.affiliation: Department of Psychiatry, Deakin University, Geelong, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D018988:Bacterial Translocation / Q000276:immunology*; D016000:Cluster Analysis; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000276:immunology / Q000382:microbiology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000276:immunology / Q000382:microbiology; D008070:Lipopolysaccharides / Q000276:immunology; D008297:Male; D008875:Middle Aged
chemical_list: D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D008070:Lipopolysaccharides