Myalgic encephalomyelitis/chronic fatigue syndrome in the context of "Differential diagnosis"

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⭐ Core Definition: Myalgic encephalomyelitis/chronic fatigue syndrome

Myalgic encephalomyelitis​/​chronic fatigue syndrome (ME/CFS) is a disabling chronic illness. People with ME/CFS experience profound fatigue that does not go away with rest, as well as sleep issues and problems with memory or concentration. The hallmark symptom is post-exertional malaise (PEM), a worsening of the illness that can start immediately or hours to days after even minor physical or mental activity. This "crash" can last from hours or days to several months. Further common symptoms include dizziness or faintness when upright and pain.

The cause of the disease is unknown. ME/CFS often starts after an infection, such as mononucleosis and it can run in families. ME/CFS is associated with changes in the nervous and immune systems, as well as in energy production. Diagnosis is based on distinctive symptoms, and a differential diagnosis, because no diagnostic test such as a blood test or imaging is available.

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Myalgic encephalomyelitis/chronic fatigue syndrome in the context of Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating, and changes in the consistency of bowel movements. These symptoms may occur over a long time, sometimes for years. IBS can negatively affect quality of life and may result in missed school or work or reduced productivity at work. Disorders such as anxiety, major depression, and myalgic encephalomyelitis/chronic fatigue syndrome are common among people with IBS, sometimes developing due to the condition.

The cause of IBS is not known but multiple factors have been proposed to lead to the condition. Theories include combinations of "gut–brain axis" problems, alterations in gut motility, visceral hypersensitivity, infections including small intestinal bacterial overgrowth, neurotransmitters, genetic factors, and food sensitivity. Onset may be triggered by a stressful life event, or an intestinal infection. In the latter case, it is called post-infectious irritable bowel syndrome.

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Myalgic encephalomyelitis/chronic fatigue syndrome in the context of Post-polio syndrome

Post-polio syndrome (PPS, poliomyelitis sequelae) is a group of latent symptoms of poliomyelitis (polio), occurring in more than 80% of polio infections. The symptoms are caused by the damaging effects of the viral infection on the nervous system and typically occur 15 to 30 years after an initial acute paralytic attack. Symptoms include decreasing muscular function or acute weakness with pain and fatigue. The same may also occur years after a nonparalytic polio infection.

The precise mechanism that causes PPS is unknown. It shares many features with myalgic encephalomyelitis/chronic fatigue syndrome, but unlike that disorder it tends to be progressive and can cause loss of muscle strength. Treatment is primarily limited to adequate rest, conservation of available energy, and supportive measures, such as leg braces and energy-saving devices such as powered wheelchairs, analgesia (pain relief), and sleep aids.

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Myalgic encephalomyelitis/chronic fatigue syndrome in the context of Long COVID

Long COVID or long-haul COVID is a group of health problems persisting or developing after an initial period of COVID-19 infection. Symptoms can last weeks, months or years and are often debilitating. The World Health Organization defines long COVID as starting three months after the initial COVID-19 infection, but other agencies define it as starting at four weeks after the initial infection.

Long COVID is characterised by a large number of symptoms that sometimes disappear and then reappear. Commonly reported symptoms of long COVID are fatigue, memory problems, shortness of breath, and sleep disorder. Several other symptoms, including headaches, mental health issues, initial loss of smell or taste, muscle weakness, fever, and cognitive dysfunction may also present. Symptoms often get worse after mental or physical effort, a process called post-exertional malaise. There is a large overlap in symptoms with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

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