38 HOW TO TREAT: MYALGIC ENCEPHALOMYELITIS / CHRONIC FATIGUE SYNDROME
38 HOW TO TREAT: MYALGIC ENCEPHALOMYELITIS / CHRONIC FATIGUE SYNDROME
18 JULY 2025 ausdoc. com. au
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Figure 5. Representation of the impact of inflammation on gastrointestinal disturbances, resulting in dysbiosis and potential neuroinflammation through the gut – brain axis.
validation of a universal diagnostic / screening test. The aetiology of ME / CFS remains elusive, and it is important to highlight that no single preceding event has been validated as a cause. The understanding of the pathomechanism of ME / CFS is evolving through multidisciplinary biomedical and clinical research.
GPs play a crucial role in the diagnosis and management of ME / CFS, including initial assessment; diagnosis; referral to specialists, if applicable, for the management and treatment of symptoms;
1. Which THREE statements regarding myalgic encephalomyelitis / chronic fatigue syndrome( ME / CFS) are correct? a It is a severe multisystemic illness. b There is no approved treatment. c There is a significant impact on quality of life and ability to participate in society. d Diagnosis is confirmed on specific laboratory testing.
2. Which ONE is the most commonly reported infectious agent associated with ME / CFS? a Influenza. b Human herpesvirus. c Epstein – Barr virus. d Coronaviruses.
3. Which THREE preceding events have commonly been reported with ME / CFS? a Significant weight loss. b Exposure to toxins. c Major life events. d Recent travel. monitoring; and follow-up. Current management strategies focus on improving the patient’ s functional capacity and quality of life using self-management strategies, accessing healthcare teams and / or pharmacotherapeutic interventions. However, it is important to highlight that no universal pharmacological intervention is approved for the treatment of ME / CFS and caution is advised.
RESOURCES
• DePaul’ s Symptom Inventory
How to Treat Quiz.
4. Which TWO statements regarding the epidemiology of ME / CFS are correct? a The average age of onset is in adolescence. b The condition affects about 17-24 million people worldwide. c ME / CFS is more common in men. d About 25 % of patients have severe ME / CFS.
5. Which THREE are differential diagnoses of ME / CFS? a Hypothyroidism. b Chronic traumatic encephalopathy. c SLE. d Rheumatoid arthritis.
6. Which TWO statements regarding the diagnosis of ME / for ME / CFS: bit. ly / 4ftiW5k
• BMJ Best Practice guidelines for ME: bit. ly / 3y1iESp
• NICE guidance; 2021: nice. org. uk / guidance / ng206
• ICC for ME / CFS; 2011: pubmed. ncbi. nlm. nih. gov / 21777306 /
• CCC for ME; 2003: bit. ly / 4dcwSyz
• IOM diagnostic criteria for ME / CFS; 2015: bit. ly / 4cUWccG
MYALGIC ENCEPHALOMYELITIS / CHRONIC FATIGUE SYNDROME
GO ONLINE TO COMPLETE THE QUIZ ausdoc. com. au / how-to-treat
CFS are correct? a Several symptoms are pathognomonic for the condition. b Numerous comorbidities coexist with ME / CFS. c The DePaul Symptom Questionnaire can be used as a screening tool. d The case definition is clear and specific.
7. Which ONE is not a feature of post-exertional malaise? a A marked, rapid physical / cognitive fatigue in response to exertion. b Immediate or delayed postexertional exhaustion. c Recovery inside of 24 hours. d Post-exertional exacerbation of other symptoms.
EARN CPD OR PDP POINTS
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Conflict of interest
• Dr Eaton-Fitch( PhD) is listed either directly or indirectly with the following patent applications: application WO2016176726A1, entitled‘ Diagnostic methods’, related to the use of single nucleotide polymorphisms in transient receptor potential ion channels to identify, screen, diagnose or manage / treat people with ME / CFS; and Australian provisional patent application 2022902253, entitled‘ Methods for detecting post-COVID-19 condition’,
8. Which THREE are appropriate management modalities in ME / CFS? a Managing the environment to limit strong scents, lights and noises. b Pacing to avoid the onset of post-exertional symptoms. c Improve exercise tolerance. d Mobility aids to improve quality of life.
9. Which TWO drugs may be appropriate in the management of ME / CFS? a Amphetamine for fatigue. b Fludrocortisone for orthostatic intolerance. c Antispasmodic agents or laxatives for gastrointestinal disturbance. d SSRI or SNRI for sleep disturbance.
10. Which THREE are associated with a poor prognosis in ME? a The duration of illness. b Presence of comorbidities. c Older age at onset. d Early diagnosis. which relates to the use of transient receptor potential ion channel dysfunction to identify, screen or diagnose people with post-COVID-19 conditions or long COVID. Dr Eaton- Fitch declares that, in preparing this document, it was conducted in the absence of any commercial relationships that could be construed as a potential conflict of interest.
• Ms M Sasso declares an Australian provisional patent application 2022902253, entitled‘ Methods for detecting post-COVID-19 condition’, relates to the use of transient receptor potential ion channel dysfunction to identify, screen or diagnose people with post-COVID-19 conditions or long COVID. She declares an absence of any commercial benefits to collaborate with this document that could characterise a potential conflict of interest.
• Professor Marshall-Gradisnik is listed either directly or indirectly with the following patent applications: application WO2016176726A1, entitled‘ Diagnostic methods’, related to the use of single nucleotide polymorphisms in transient receptor potential ion channels to identify, screen, diagnose or manage / treat people with ME / CFS; and Australian provisional patent application 2022902253, entitled Methods for detecting post-COVID-19 condition, which relates to the use of transient receptor potential ion channel dysfunction in identifying, screening or diagnosing people with post-COVID-19 condition or long COVID. Professor Marshall- Gradisnik declares that her participation in preparing this document was conducted in the absence of any commercial relationships that could be construed as a potential conflict of interest.
References Available on request from howtotreat @ adg. com. au