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. 2020 Feb 26;140:109648.
doi: 10.1016/j.mehy.2020.109648. Online ahead of print.

From IBS to ME - The Dysbiotic March Hypothesis

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From IBS to ME - The Dysbiotic March Hypothesis

Arnold Berstad et al. Med Hypotheses. .
Free article


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.

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.

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