AHMF: Conf 2001: HL Butt

'Bacterial Colonosis' in Patients with Persistent Fatigue

Butt HL, Dunstan RH, McGregor NR, Roberts TK

Collaborative Pain Research Unit (CPRU),
Department of Biological and Chemical Sciences,
University of Newcastle,
Newcastle,
Australia.

'Bacterial Colonosis' (BC) in patients with persistent fatigue is a disease entity that has not been described in medical literature. Patients with this condition usually present with multiple disorders including gastrointestinal symptoms, characterized by an absence of gastrointestinal inflammation and a marked alteration of intestinal microbial flora. This condition of unknown aetiology is manifested in patients with Chronic Fatigue Syndrome (CFS), Fibromyalgia, Irritable Bowel Syndrome, and Autism. In a study of 1390 fatigued patients, fatigue presentation in patients with BC was more severe than patients without BC (p<0.015). Similarly muscular pain (face, neck, shoulder and lower back) in fatigued patients with BC was significantly more severe (p<0.01) than patients with minimal or no BC. The distribution of faecal intestinal microbial flora in this study population was markedly altered. The mean % distribution for the organism Escherichia coli was 36.6% of the total aerobic flora, a count significantly lower (p<0.001) than those found in healthy subjects (70-95%). By contrast the lactic acid bacteria Enterococcus spp was significantly higher (p<0.001, 28.7% of the total aerobic flora in fatigued patients ) than with the healthy subjects (3-5%). Patients with chronic fatigue also had marked decrease in Bifidobacterium spp. count (<0.35% of the total anaerobic flora). Changes in the gastrointestinal microbial ecology are significantly associated with fatigue symptoms. A high faecal enterococcal count significantly and positively correlates with neurological and cognitive functions (nervousness (p<0.05), memory loss (p<0.01), forgetfulness (p<0.01), confusion (p<0.05), mind going blank (p<0.01)). Similarly a high aerobe/anaerobe ratio significantly and positively correlates with poor colonic functions, poor digestion, and malabsorption of the gastrointestinal tract.