How peptic ulcer disease could potentially lead to the lifelong, debilitating effects of chronic fatigue syndrome: an insight by Kuo et al. 2021

Abstract
Chronic Fatigue Syndrome (CFS) has been defined as unexplained relapsing or persistent fatigue for at least 6 consecutive months. Immuno-inflammatory pathway, bacterial infection, and other causes play essential roles in CFS. Helicobacter pylori infection is one of the most common causes of foregut inflammation, leading to peptic ulcer disease (PUD). This study aimed to analyze the risk of CFS development between patients with and without PUD. Other related factors were also analyzed. We performed a retrospective, nationwide cohort study identifying patients with or without PUD respectively by analyzing the Longitudinal Health Insurance Database 2000 (LHID2000), Taiwan. The overall incidence of CFS was higher in the PUD cohort than in the non- PUD cohort (HR = 2.01, 95% CI = 1.75–2.30), with the same adjusted HR (aHR) when adjusting for age, sex, and comorbidities. The sex-specific PUD cohort to the non-PUD cohort relative risk of CFS was significant in both genders. The age-specific incidence of CFS showed incidence density increasing with age in both cohorts. There is an increased risk of developing CFS following PUD, especially in females and the aging population. Hopefully, these findings can prevent common infections from progressing to debilitating, chronic conditions such as CFS.

Full text at: https://www.nature.com/articles/s41598-021-87018-z

 

I think we have seen previous studies from this Taiwanese database, although not in a prominent journal such as Scientific Reports.

I think this study has the same issues that we previously noted in an American prevalence study that used ICD-codes: these probably don't select CFS as it is normally used and defined.

A quick look at table 2. for example shows no major difference in CFS prevalence among males and females and that a clearly higher incidence as age increases. The 65+ age group has more than double the number of CFS cases than the ≤49 age group.

Little is known about ME/CFS but one of the few things that seem clear is that it is clearly more common in females and that the incidence doesn't peak in the 65+ age group. So that suggests major problems with this study.

 

I think my sudden viral onset in 1991 activated an h pylori infection. I went 5 years without being dx and finally treated. It was a virologist who decided to test me.

 

My daughter was found to have h pylori within months after glandular fever when gp was looking at other potential causes of fatigue .

There are correlations between h pylori and liver and gallbladder issues too .

 

Does having h pylori confer any benefits on humans? I've read that it is estimated that 50% of humans are infected with it, so wondered if it did some good to offset the bad.

 

There are different strains of h pylori, some are highly virulent and can develop into gastric cancer. The strain I had was making my symptoms worse and worse over the years.

My grandmother died of gastric cancer. Possibly some genetic strain?