Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome.
Steinsvik, Elisabeth K, Hausken, Trygve, Fluge, Øystein et al. · Scandinavian journal of gastroenterology · 2023 · DOI
Quick Summary
Many people with ME/CFS experience stomach and digestive problems like bloating, nausea, and abdominal pain. This study used ultrasound imaging to examine how the stomach processes food in 20 ME/CFS patients with digestive complaints, comparing them to healthy people. The researchers found that ME/CFS patients' stomachs don't relax and expand normally after eating, and they are more sensitive to discomfort, similar to a condition called functional dyspepsia.
Why It Matters
This study fills an important gap by providing objective evidence of abnormal stomach function in ME/CFS rather than attributing symptoms solely to psychological causes. Understanding that ME/CFS patients share gastric dysfunction patterns with functional dyspepsia may guide more targeted treatment strategies. These findings validate patient-reported gastrointestinal symptoms as having a measurable physiological basis.
Observed Findings
75% of patients reported fullness/bloating, 45% reported abdominal pain, and 35% reported nausea
Ultrasound showed reduced proximal gastric measurements after a meal compared to healthy controls (p<0.01)
Patients had larger fasting antral areas than controls (p=0.019)
Patients showed stronger symptomatic responses to liquid meal challenge regarding epigastric pain, discomfort, and nausea (p<0.05)
90% of patients reported normal bowel movement frequency but high dissatisfaction with bowel habits and life disruption
Inferred Conclusions
ME/CFS patients demonstrate impaired gastric accommodation (inability of the stomach to relax and expand after eating)
ME/CFS patients exhibit visceral hypersensitivity (heightened sensitivity to stomach sensations)
The gastrointestinal symptom profile and pathophysiology in ME/CFS resembles functional dyspepsia rather than irritable bowel syndrome
Gastrointestinal dysfunction in ME/CFS has an objective physiological basis measurable by ultrasound
Remaining Questions
Does gastric dysfunction improve or worsen with ME/CFS disease progression over time?
What This Study Does Not Prove
This study does not prove that gastric dysfunction causes ME/CFS fatigue or other systemic symptoms—it only documents that the two conditions frequently co-occur. The small sample size and selection of symptomatic patients limits generalizability to all ME/CFS patients. The study does not establish whether these motility changes are primary to ME/CFS or secondary to other disease processes.