Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome.

Abstract

BACKGROUND: Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge gap in the literature concerning gastrointestinal motility features and  detailed symptom description. OBJECTIVE: In this study, we aimed to characterize  gastric motility and gastric symptoms in response to a liquid meal. METHODS: We  included 20 patients with ME/CFS with abdominal complaints who were recruited to  a double-blind randomized placebo-controlled trial of Rituximab. The patients of  this sub study were examined with an ultrasound drink test, and gastrointestinal  symptoms were evaluated using the Rome III questionnaire and Irritable Bowel  Syndrome Symptom Severity Scale (IBS-SSS) questionnaire. RESULTS: We found that  patients commonly reported fullness/bloating (75%), abdominal pain (45%) and  nausea (35%). Ultrasound measurements revealed lower proximal measurements of the  stomach after a meal (p < 0.01) and larger fasting antral area (p = 0.019)  compared to healthy controls. The patients had a stronger symptomatic response to  the liquid meal compared to healthy controls regarding epigastric pain,  discomfort and nausea (p < 0.05).Ninety percent of the patients reported bowel  movement frequencies within the normal range but scored high on bowel habit  dissatisfaction and life disruption. CONCLUSION: The patients presented with  fullness/bloating, nausea and epigastric pain, showed signs of impaired gastric  accommodation and visceral hypersensitivity, showing that the gastrointestinal  symptoms of ME/CFS patients are similar to functional dyspepsia.Key  summary Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge  gap in the literature concerning gastrointestinal motility features and detailed  symptom description. • In this study, patients with ME/CFS had signs of impaired  gastric accommodation after a liquid meal. • Out of 20 patients, 15 patients  reported fullness/bloating, 9 reported abdominal pain, and 7 reported nausea. The  patients showed signs of visceral hypersensitivity on a drink test. • Our  findings suggest that patients with ME/CFS share many similarities with patients  with Functional Dyspepsia. The findings were not typical for Irritable Bowel  Syndrome.