TO TABLE OF
The latest information on research, treatment and diagnosis
Children or adolescents with chronic fatigue syndrome (CFS) and irritable bowel syndrome
(IBS) may be able to find relief from an ancient remedy. A study published in the January 2001 Journal
of Pediatrics found that peppermint oil may provide relief for children experiencing mild to moderate
abdominal pain associated with IBS.
Researchers studied 42 children ages 8 to 17 with IBS who were given either a capsule
oil or placebo.
After two weeks, the children reported a dramatic reduction in pain, which was measured
tools such as the Gastrointestinal Symptom Rating Scale and daily diaries. Three-quarters (76%) of the
children who received peppermint capsules reported improvement in pain but only 19% of the children who
received a placebo reported improvement.
Other clinical studies have shown that peppermint oil can relax the lower esophageal
relieve symptoms of dyspepsia and colon spasms. Researchers suggest that clinicians consider using peppermint
oil to treat moderate pain in children with IBS. However, they caution that although none of the children
in their study experienced any adverse side effects, previous study participants taking peppermint oil
experienced a few side effects, such as mild rectal burning and heartburn.
Patients with vascular syncope studied for CFS
In a February 2001 article in
Journal of Medicine, researchers with the
Royal Victoria Infirmary in Newcastle investigated whether patients with a
primary diagnosis of vasovagal syncope also had CFS.
Sixty-two patients underwent a head-up tilt-table test and examination and then completed
questionnaire for CFS. The study revealed that 21% of the patients met CFS criteria but none of the 119
healthy controls did.
In addition, almost a quarter of the patients with vasovagal syncope who did not meet
the CFS case
definition criteria still had a high prevalence of CFS symptoms, such as sleep disturbance, sore throat,
myalgia, and fatigue.
The study raises the possibility that CFS and vasovagal syncope may share a common pathophysiology.
Role of mononucleosis in chronic illnesses
Researchers at the University of
Washington studied how often acute mononucleosis precipitates chronic illness
and attempted to describe the psychosocial, clinical, and demographic features
that characterize patients who report no recovery.
The study examined 150 patients with infectious mononucleosis and asked them to assess
at two and six months. Self-assessed failure to recover was reported by 38% of patients at two months
and by 12% at six months.
Those who had not recovered reported a persistent illness characterized by fatigue and
status. They also reported poorer general health and worse pain. Patients then underwent physical examinations
and laboratory tests, but no disease was diagnosed.
The study, published in the American Journal of Medicine (November 2000), suggests
patients with viral infections do not fully recover and that persistent illness is characterized by fatigue
and impaired functional status.
The researchers said that those patients who did not recover resemble patients with
the theory that chronic fatigue syndrome follows certain infections.
CFS memory deficits
Researchers from the University of Alberta, Canada,
have found further evidence of neurocognitive impairments in CFS patients.
The performance of 20 CFS patients on four tests of working memory was compared to that
of 20 healthy
controls. Tests assessed the ability to remember a series of numbers, remember facts when given a time
deadline, and sustain attention to memorization tasks when distracted.
The CFS patientsí memory deficits compared to controls were most prominent during demanding
required heavy concentration and the ability to efficiently switch between different types of information
Results of the study were published in the March 2001 issue of the Journal of International
Subset of patients with Sjogrenís
Many CFS patients have coexisting conditions.
A study published
in the January 2001 issue of the Journal of Rheumatology shows that a subset of CFS patients may
syndrome, an autoimmune disorder that can cause joint aches and dry eyes and
Researchers from the University of Medicine and Dentistry of New Jersey-New Jersey Medical
25 patients and 18 healthy controls for Sjogrenís using salivary gland biopsies, tear production tests,
and blood tests for antinuclear antibodies.
None of the controls met the diagnostic criteria for Sjogrenís, but eight of the CFS
The researchers concluded that a small subset of patients with CFS may have primary Sjogrenís syndrome.
Doctor-patient perspectives on CFS
A study that looked out how general practitioners
chronic fatigue syndrome (CFS) and what they think of their patients was reported on in The Journal of
Chronic Fatigue Syndrome (Vol. 7, #4; 2001).
The study polled 120 general practitioners (GPs) on how frequently they diagnosed CFS,
the causes and
attributions of patientsí complaints, patientsí expectations, and their opinion on communicating with
Two hundred and eleven CFS patients were then asked the same questions and the results
When asked to compare their relationships with their CFS patients to other patients,
89% of the GPs
responded that CFS patients took more time, 73% believed their CFS patients regularly caused problems,
43% reported communication problems, and 31% rated contact and cooperation as poor.
About half of the physicians reported less empathy for CFS patients as compared to other
More than half of the CFS patients said medical specialists did not take their complaints seriously and
did not sympathize with them.
The study also showed a large discrepancy between what GPs and patients believe the
cause of CFS to
be. Most patients attributed their symptoms to physical factors while most physicians attributed complaints
to psychological factors.
The study showed a mere 10% of the practitioners felt they knew enough about CFS to
advise their patients
and only half of the GPs reported using the CFS diagnosis, primarily because they were unfamiliar with
the criteria (69%). About 20% did not think CFS was a legitimate illness.
The lack of knowledge about the condition underscores the need
to develop specific guidelines for health care practitioners to identify and
Keep in mind that research studies with fewer than 500
patients are generally not considered statistically valid and may be questioned
by the medical community. The Chronicle reports on smaller studies due to the
lack of large-scale research projects and to keep you updated on emerging
Experts Discuss Research
For more information on The CFIDS Associationís March research
symposium on neuroendocrine aspects of CFS, see the Spring 2001 issue of The CFS Research Review.