# For those of us with IBS - why we get it with CFS



## Susan Purry (Nov 6, 2001)

This was posted on the co-cure list. It may explain why we get IBS as part of our CFS.


> quote:Source: Sydney Morning HeraldDate: May 4, 2002Author: Julie Robotham, Medical WriterURL: http://www.smh.com.au/articles/2002/05/03/1019441434909.html Brain link to fatigue syndrome------------------------------*An area of the brain that controls the stomach receives substantially lessblood in some people with chronic fatigue syndrome, a study shows. *The findingadds more weight to the argument that the controversial illness is biological,not psychological.Brain scans of 40 chronic fatigue patients were carried out by Adelaidescientists and compared against the scans of healthy people. The director ofnuclear medicine at Queen Elizabeth Hospital, Dr Steven Unger, who headed thestudy along with neurologist Dr Rey Casse, said: "There was a very strongchange in cerebral blood flow in patients."*The study showed a reduction in blood flow to the brain's insula cortex,which governs the smooth muscle in the gut. *Unexplained stomach and bowelsymptoms are common complaints for chronic fatigue patients.The findings also showed a 20 per cent reduction in blood flow to the leftlateral temporal lobe, which controls access to words, in younger chronicfatigue patients. Severe sufferers often experience difficulty expressingthemselves.In separate research, endocrinologist Dr Richard Burnett, of the RoyalAdelaide Hospital, has shown that chronic fatigue patients who reportgastric symptoms empty fluid from their guts at less than half the speed ofpeople who are well."Talking to patients, about half of them have some kind of [gut symptoms],such as abdominal bloating after eating a small meal," he said. "A delay inliquids means a central problem. It comes from the brain."--------© 2002 The Sydney Morning Herald --------------------------------------------- Co-Cure Web Site: http://www.co-cure.org/ Send posts to mailto:CO-CURE###listserv.nodak.edu Join or leave the list at http://www.co-cure.org/sub.htm Co-Cure is not a discussion list. Please do not reply to the list. ---------------------------------------------


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## eric (Jul 8, 1999)

Hi Susan, cfs is really not something I study in depth, but as I study IBS there are a lot of references to cfs since it is comorbid in a lot of IBSers.I do not know what the symptoms just cfs patients suffer with exactly though.However, all IBS patients have a problem with serotonin regulation though, between the brain and the gut and back. So I can only tell you what I have read in regards to the two and I cannot tell you I understand it completely when it comes to CFS and Fibro. or even totally for IBS.That neurotransmitter is involved in a lot of the bodies functions.I will try to post some on this and keep it really simple, even though its much more complex really.The researchers know that in IBS the serotonin is dysregulating between the gut and the brain and back though, and that the brain recieves the signal from the gut and it does not register like it does in normal people. The signal is suppose to go to a part of the brain that would release endorphines for digestion, as it does in normal people. That part of the brain is not activated in IBS. Instead a part of the brain that is activated has to do with emotions and anxiety among other things, and this part is "turned up." This in turn causes long term chronic anxiety, both conciouly and subconciously.For the record, about thirty percent of IBSers seem to get IBS from a previous gut infection that inflammes the colon and the receptors in the gut. When this inflammation goes away the person who is prone to IBS is left with IBS. The chronic stress seems to alter the fight or flight responce. This in turn seems to activates the HPA axis I know you know about. This in turn seems to generate more symptoms by neurogenic inflammation (there is no antigen casuing the inflammation) and keeps the IBS in the vicious cycle. This may also be why some people have food sensitivites or think they do, because the food is already bugging the inflamed mast cells.J Gastroenterol Hepatol 1998 Oct;1310:980-9 Mast cells: a possible link between psychological stress, enteric infection, food allergy and gut hypersensitivity in the irritable bowel syndrome. Gui XY. University of Sydney Department of Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia. Intestinal mast cell activation (degranulation), which results from previous enteric infection and/or intestinal allergy, may play a central role in the gut hypersensitivity in both motor response and visceral perception in the Irritable Bowel syndrome. This occurs through various mediators acting on enteric neurons and smooth muscle cells. Psychological stress may trigger this sensitive alarm system via the brain-gut axis. Publication Types: Review Review, Tutorial PMID: 9835312Am J Med 1999 Nov 8;107Emerging disease model for functional gastrointestinal disorders. Mayer EA. Division of Digestive Diseases, University of California Los Angeles School of Medicine, USA. In response to perceived or experienced change that is considered threatening to the individual, the central nervous system mounts a stereotypic response that decreases the sensitivity to pain, modulates the autonomic nervous system outflow, and activates the hypothalamic-pituitary-adrenal (HPA) axis. This response of the "emotional motor system" may or may not be associated with the conscious experience of feelings of fear or anxiety. Alterations in these response systems (either up- or downregulation) may produce symptoms, such as viscero-somatic hypersensitivity, altered bowel habits, or increased anxiety. Publication Types: Review Review, Tutorial PMID: 10588168Gender differences in fibromyalgia and other related syndromes. Yunus MB. Section of Rheumatology, University of Illinois College of Medicine at Peoria, 1 Illini Dr, PO Box 1649, Peoria, IL 61656, USA. yunus###uic.edu Fibromyalgia syndrome is characterized by widespread musculoskeletal pain, fatigue, poor sleep, and tenderness on palpation at multiple sites called tender points. It occurs mostly among women; only about 10% of patients are men. Two recent studies showed that women had significantly more common fatigue, morning fatigue, "hurt all over," a greater total number of symptoms, as well as a greater number of tender points. Gender differences have also been reported in other related syndromes such as tension headache, migraine, irritable bowel syndrome, chronic fatigue syndrome, and temporomandibular disorder. Although the mechanisms of gender differences in these illnesses are not fully understood, they are likely to involve an interaction between biology, psychology, and sociocultural factors. PMID: 11974674 I am not sure I answered any specifics for you. I don't think they know exactly where all these conditions come together, although it seems they share some very common mechanisms. There are not even sure that IBS isn't a more of a brain problem then a gut problem, even though the problem starts in the gut.These brain studies are starting to answers some of these questions though for both cfs and for IBS.If I can help more let me know. You may want to study in depth the brain scans in IBS and if you can get them on the net, the brain scans here on CFS and then compare whats going on in each. That HPA axis seems to be one convergence however in IBS and CFS and a lot of other conditions, although its total role is still somewhat unclear, they have found a lot of the research fits.


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## eric (Jul 8, 1999)

I am just pulling up some info for you on all this, but am not reading it in depth at the moment. http://freespace.virgin.net/david.axford/update7.htm This is interesting."Research in England shows higher levels of serotonin in ME/CFS patients. Low levels of serotonin createdepression and sleep disorders, while higher levels induce fatigue and poor response to antidepressants." http://www.disabilityuk.com/masterpages/cfsm.htm http://chronicfatigue.about.com/library/weekly/aa050300a.htm


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## trbell (Nov 1, 2000)

explains to me the connection to smoking and hypnosis.tom


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## eric (Jul 8, 1999)

What do you mean Tom?


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## eric (Jul 8, 1999)

Susan, this is some more on all this. http://www.macmcm.com/acg/acg99_gdf.htm http://www.macmcm.com/pcp/pcp2000_01.htm


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## Susan Purry (Nov 6, 2001)

Hi eric. I know about the serotoin and HPA factor in CFS and IBS. Thanks for the links though. It was the reduced blood flow in CFS to the brain which controls the stomach that I was curious about - whether you have come across any similar studies in IBS patients without CFS...?


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## Susan Purry (Nov 6, 2001)

As general information, here are some stats about the percentage of Fibro patients also having IBS:


> quote:There are several clinical studies showing that fibromyalgia (FM) frequently coexists with IBS; that is, IBS is more common in people with FM than in the general population, and FM is more common in people with IBS. Researchers in 1999 conducted complementary studies of the prevalence of FM in IBS patients (and matched controls), and of IBS in fibromyalgia patients. In the IBS study, about 32% of the IBS patients had fibromyalgia (compared to 4% of the controls). Similarly, 32% of the FM patients had IBS. http://fmaware.org/patient/related/ibs.htm


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## trbell (Nov 1, 2000)

eric, from the little I know smoking reducesblood flow in the brain and the gut and I also suspect it affects serotonin levels and this is prossivly how it affects cfs, ibs, and a lot of other things. Hypnosis possibly has the same kind of effect as does food intake?tom


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