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Chronic fatigue syndrome

From: mansiwat ,cavila and Bodlong

This article is about the medical condition Chronic fatigue syndrome. For the symptom chronic fatigue, see Fatigue (medical).

Chronic fatigue syndrome
Classification and external resources
ICD-10	G93.3
ICD-9	780.71
DiseasesDB	1645
MedlinePlus	001244
eMedicine	med/3392 ped/2795
MeSH	D015673

Chronic fatigue syndrome (CFS)

is the most common name used to specify a medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially relieved by rest, nor caused by other medical conditions. The disorder may also be referred to as myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS), or several other terms. Although classified by the World Health Organization under Diseases of the nervous system, the etiology (cause or origin) of CFS is unknown, and multiple psychological and physiological factors may contribute to the development and maintenance of symptoms. There is no diagnostic laboratory test or biomarker for CFS.

Symptoms of CFS include post-exertional malaise; unrefreshing sleep; widespread muscle and joint pain; sore throat; cognitive difficulties; chronic, often severe, mental and physical exhaustion; and other characteristic symptoms in a previously healthy and active person. Persons with CFS may report additional symptoms including muscle weakness, increased sensitivity to light, sounds and smells, orthostatic intolerance, digestive disturbances, depression, and cardiac and respiratory problems. It is unclear if these symptoms represent co-morbidconditions or are produced by an underlying etiology of CFS.

Fatigue is a common symptom in many illnesses, but CFS is comparatively rare. Estimates of CFS prevalence vary widely, from 7 to 3,000 cases of CFS for every 100,000 adults, but national health organizations have estimated more than 1 million Americans and approximately a quarter of a million people in the UK have CFS. CFS occurs more often in women than men, and is less prevalent among children and adolescents. The quality of life is "particularly and uniquely disrupted" in CFS.

There is agreement on the genuine threat to health, happiness and productivity posed by CFS, but various physicians' groups, researchers and patient advocates promote different nomenclature, diagnostic criteria, etiologic hypotheses and treatments, resulting in controversy about many aspects of the disorder. The name CFS itself is controversial as many patients and advocacy groups, as well as some experts, want the name changed as they believe that it stigmatizes by not conveying the seriousness of the illness.

Signs and symptoms

Onset

The majority of CFS cases start suddenly,^[33] usually accompanied by a "flu-like illness"^[5] while a significant proportion of cases begin within several months of severe adverse stress.^[33][34][35] An Australian prospective study found that after infection by viral and non-viral pathogens, a sub-set of individuals met the criteria for CFS, with the researchers concluding that "post-infective fatigue syndrome is a valid illness model for investigating one pathophysiological pathway to CFS".^[36] However, accurate prevalence and exact roles of infection and stress in the development of CFS are currently unknown.

Symptoms

The most commonly used diagnostic criteria and definition of CFS for research and clinical purposes were published by the United States Centers for Disease Control and Prevention(CDC).^[5] The CDC definition of CFS requires the following two criteria be fulfilled:^[3]

1. A new onset (not lifelong) of unexplained, persistent fatigue unrelated to exertion and not substantially relieved by rest, that causes a significant reduction in previous activity levels.
2. Four or more of the following symptoms that last six months or longer:
   • Impaired memory or concentration
   • Post-exertional malaise, where physical or mental exertions bring on "extreme, prolonged exhaustion and sickness"
   • Unrefreshing sleep
   • Muscle pain (myalgia)
   • Pain in multiple joints (arthralgia)
   • Headaches of a new kind or greater severity
   • Sore throat, frequent or recurring
   • Tender lymph nodes (cervical or axillary)

Other common symptoms include:

• Irritable bowel, abdominal pain, nausea, diarrhea or bloating
• Chills and night sweats
• Brain fog
• Chest pain
• Shortness of breath
• Chronic cough
• Visual disturbances (blurring, sensitivity to light, eye pain or dry eyes)
• Allergies or sensitivities to foods, alcohol, odors, chemicals, medications or noise
• Difficulty maintaining upright position (orthostatic instability, irregular heartbeat, dizziness, balance problems or fainting)
• Psychological problems (depression, irritability, mood swings, anxiety, panic attacks)^[37]

The CDC recommends that persons with symptoms resembling those of CFS consult a physician to rule out several treatable illnesses: Lyme disease,^[3] "sleep disorders, depression,alcohol/substance abuse, diabetes, hypothyroidism, mononucleosis (mono), lupus, multiple sclerosis (MS), chronic hepatitis and various malignancies.Medications can also cause side effects that mimic symptoms of CFS

Functioning

People report critical reductions in levels of physical activity and a reduction in the complexity of activity has been observed,with reported impairment comparable to other fatiguing medical conditions including late-stage AIDS,lupus, rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and end-stage renal disease.CFS affects a person's functional status and well-being more than major medical conditions such as multiple sclerosis, congestive heart failure, or type II diabetes mellitus The severity of symptoms and disability is the same in both genders with strongly disabling chronic pain, but despite a common diagnosis the functional capacity of individuals with CFS varies greatly. While some lead relatively normal lives, others are totally bed-ridden and unable to care for themselves. Employment rates vary with over half unable to work and nearly two-thirds limited in their work because of their illness. More than half were on disability benefits or temporary sick leave, and less than a fifth worked full-time

Cognitive functioning

A 2010 meta-analysis concluded cognitive symptoms were principally resultants of decreased attention, memory, and reaction time. The deficits were in the range of 0.5 to 1.0 standard deviations below expected and were judged likely to affect day-to-day activities. Simple and complex information processing speed and functions entailing working memory over long time periods were moderately to extensively impaired. These deficits are generally consistent with those reported by patients. Perceptual abilities, motor speed, language, reasoning, and intelligence did not appear to be significantly altered.

how jesogatherapy cure the chronic fatigue syndrome

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