Irritable bowel syndrome (IBS) is often associated with other unexplained complaints like chronic fatigue syndrome (CFS), fibromyalgia and myalgic encephalopathy (ME). The pathogenesis of the relationship is unknown. Intestinal dysbiosis may be a common abnormality, but based on 1100 consecutive IBS patients examined over a nine years period, we hypothesize that the development of the disease, often from IBS to ME, actually manifests a "dysbiotic march". In analogy with "the atopic march" in allergic diseases, we suggest "a dysbiotic march" in IBS; initiated by extensive use of antibiotics during childhood, often before school age. Various abdominal complaints including IBS may develop soon thereafter, while systemic symptom like CFS, fibromyalgia and ME may appear years later.
Keywords: Antibiotics; Candida albicans; Childhood; Chronic fatigue syndrome (CFS); Dysbiotic march; Fibromyalgia; Gut microbiota; Gut-brain axis; Intestinal dysbiosis; Irritable bowel syndrome (IBS); Lactobacilli; Myalgic encephalopathy (ME); Tryptophan metabolites.
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome.Microbiome. 2017 Apr 26;5(1):44. doi: 10.1186/s40168-017-0261-y. Microbiome. 2017. PMID: 28441964 Free PMC article.
Eukaryotes in the gut microbiota in myalgic encephalomyelitis/chronic fatigue syndrome.PeerJ. 2018 Jan 22;6:e4282. doi: 10.7717/peerj.4282. eCollection 2018. PeerJ. 2018. PMID: 29375937 Free PMC article.
Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.Neuro Endocrinol Lett. 2014;35(6):445-53. Neuro Endocrinol Lett. 2014. PMID: 25433843
Infection Elicited Autoimmunity and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: An Explanatory Model.Front Immunol. 2018 Feb 15;9:229. doi: 10.3389/fimmu.2018.00229. eCollection 2018. Front Immunol. 2018. PMID: 29497420 Free PMC article. Review.
Examining clinical similarities between myalgic encephalomyelitis/chronic fatigue syndrome and D-lactic acidosis: a systematic review.J Transl Med. 2017 Jun 7;15(1):129. doi: 10.1186/s12967-017-1229-1. J Transl Med. 2017. PMID: 28592308 Free PMC article. Review.