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Pubmed-Can Small Fiber Neuropathy Explain the Overlap Gastrointestinal and Non-gastrointestinal Symptoms in Some Irritable Bowel Syndrome Patients?

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J Neurogastroenterol Motil. 2024 Jan 30;30(1):116-118. doi: 10.5056/jnm23039.

TO THE EDITOR: We are writing to address a potentially im- portant and unexplored pathology linking irritable bowel syn- drome (IBS) and other chronic pain syndromes. The readers of this journal are not foreign to IBS. Suffice to say, IBS constitutes both gastrointestinal (GI) and extra-GI symptoms including chronic pain syndromes, such as fibromyalgia and chronic fa- tigue syndrome.1-4 Recent studies have shown that fibromyalgia and chronic fatigue syndrome often coexist with small fiber neuropathy (SFN).5-7 SFN is underdiagnosed as health care professionals have little knowledge of the condition, yet it is also a common neurological disorder that manifests with pain, numbness, paresthesia, and/or autonomic dysfunction.5 One study published in Seminars in Arthritis and Rheumatism found that 49% of fibromyalgia patients also had SFN.6 Another study published in the American Journal of Respiratory and Critical Care Medicine found that 30% of chronic fatigue syndrome pa- tients had definite SFN.7 Unfortunately, the diagnosis of SFN is complex and requires a combination of symptoms, signs, absence of a large fiber neuropathy, and the highest diagnostic standard for confirmation of SFN is by skin biopsy for intra-epidermal nerve fiber density.8

PMID:38173163 | DOI:10.5056/jnm23039

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