Chronic Fatigue Syndrome: Symptoms and Diagnosis

The modern world demands from the person the maximum return and constant pressure. Just relax a little - and you're already out of the loop. Therefore, most people all the time somewhere in a hurry, live in a furious rhythm and do not give themselves a moment's peace.

This behavior has the opposite side of the medal in the form of health problems. And they pour out into completely different diseases: someone overcomes frequent ARI, someone has hormonal failures, and someone even earns cancer in this way. The wording of the underlying diseases is more or less clear to the common man in the street. But since the end of the last century, an official separate disease has appeared in medicine under the strange name "chronic fatigue syndrome". Yes, yes, chronic fatigue, for today, this is a disease, and not just a temporary condition. And like every disease, chronic fatigue syndrome has its own causes, symptoms and methods of treatment. Since the state of prolonged fatigue has accompanied almost every one of us at least once in a lifetime, let's try to figure out where the line between norm and pathology is? What is considered ordinary fatigue, and what is already a disease? How to determine the presence of chronic fatigue syndrome in humans? You can find answers to these questions by reading this article.

Definition

More susceptible to the development of the syndrome of chronic fatigue of a female.

The official definition of chronic fatigue syndrome sounds approximately like this: chronic fatigue syndrome (CFS) is a disease characterized by excessive physical and mental fatigue, duration of at least 6 months, not passing after rest or sleep, accompanied by numerous joint, muscle, infectious and neuropsychological symptoms. Thus, it becomes clear that fatigue can be considered a disease only if it exists for at least six months and in combination with other symptoms.

The first mention of the syndrome of chronic fatigue date back to the 30th years of the twentieth century, but until 1988 the formulation was different. Synonyms of CFS are the following formulations: benign myalgic encephalomyelitis, chronic mononucleosis, myalgic encephalopathy, postvirus fatigue syndrome. This is what the disease was called during the 20th century. Such different formulations of the same state were related to the search for immediate causes of CFS. Since the only reason was not established, the scientists decided to associate the name with the main symptom. So, in 1988, the Americans proposed the term "chronic fatigue syndrome", and since 1994 the name has become international.

Causes of CFS

A reliable source of development of CFS has not yet been established. There are only assumptions about the leading role of this or that process in each specific case. Among the states with which the relationship of CFS is directly traced, it is worth noting the following:

• transferred viral infections (Epstein-Barr virus, Coxsackie group B, cytomegalovirus, herpesvirus type 6, hepatitis C virus, enteroviruses);
• violation of control of body functions from the nervous system. Especially it concerns the autonomic nervous system, the sphere of higher nervous activity (memory, thinking, and so on);
• mental disorders. In most cases, CFS reveals precursors in the form of mood changes, feelings of unmotivated anxiety;
• stay in a state of chronic stress;
• an unfavorable ecological situation in combination with an incorrect way of life. Residents of large cities working "for wear", with an inadequate diet, without sufficient physical activity in conditions of constant lack of sleep - the first applicants for CFS.

It can not be said that any one of the above factors is decisive or more significant. Modern scientists believe that it is the coincidence of a number of conditions that leads to the development of CFS.

There are predisposing factors of CFS. It:

• female sex (according to statistics, 60-85% of all suffering from this pathology are women);
• increased emotionality (choleric patients suffer more often from CFS);
• age 30-49 years;
• availability of a responsible profession (doctors, firefighters, EMERCOM employees, pilots and the like).

Symptoms

The main symptom of CFS is physical and mental fatigue, which bothers a person for at least 6 months. Fatigue seems to the patient beyond the bounds. "I'm squeezed like a lemon," "I'm exhausted to exhaustion," "I was like being passed through a meat grinder," this is how patients with SCS formulate their feelings. The difference between simple fatigue and chronic fatigue syndrome is that with CCS, no rest does not help restore the body's strength. No sleep, no vacation with a change of scenery in no way affect the feeling of fatigue. Do not confuse the state of CFS with depression. With depression, a person does not want to do anything, does not strive for anything, and under the circumstances of the SCU the situation is reversed - the desires do not coincide with the possibilities.

In addition to feeling tired, the patient with CFS also has other symptoms:

• pain. It can be joint and muscle pains, pains in the abdomen, throat, in the chest, in the eyes, bones, in the perineum, in the genitals, in the skin, headaches. The pain has the ability to migrate from place to place, has no stability. Pain in the same place is different in sensations ("yesterday shot, today whines or tunic");
• deterioration of memory and attention. These changes are noticed by the patient and cause him a lot of trouble;
• sleep disturbances (difficulty falling asleep, intermittent night sleep and, as a consequence, daytime sleepiness);
• decreased efficiency;
• irritable bowel syndrome (bloating, nausea, diarrhea, abdominal pain);
• trembling and sweating at night;
• decreased or increased body temperature (up to 36.0 ° C and 38.0 ° C, respectively);
• difficulty breathing ("something prevents breathing"), chronic cough in the absence of objective reasons for it;
• increased sensitivity to noise, light;
• sudden intolerance of smells and flavors that were previously liked;
• problems associated with changing the position of the body. In this case, there are in view of dizziness, rapidity of the pulse, a pre-stupor state when the position of the body changes from horizontal to vertical;
• mood instability, anxiety, irritability, apathy, uncaused fears;
• decrease or increase in body weight;
• frequent colds.

Of course, not all symptoms are observed in every patient. Usually fatigue accompanies several additional complaints.

When analyzing all the above symptoms, one important fact should be borne in mind: they can all be regarded as indirect signs of CFS only if there are no other health problems. That is, for example, if a person suffers from migraine and has intolerance of bright light and loud sounds, this can not be regarded as a symptom in the case of CFS. Modern medicine has identified a whole group of conditions, the presence of which obviously excludes the possibility of setting such a diagnosis as chronic fatigue syndrome. These include:

• chronic somatic diseases (hepatitis B or C, hypothyroidism, diabetes mellitus, severe anemia, chronic renal disease insufficiency, chronic heart failure, bronchial asthma, oncological diseases and so on);
• some mental disorders (anorexia or bulimia, dementia, depression, manic-depressive disorder, schizophrenia);
• addiction to alcohol or drugs for 2 years before the onset of symptoms of chronic fatigue syndrome;
• excess body weight (obesity of the third degree);
• taking medications that can themselves provoke a feeling of general weakness (for example, muscle relaxants, tranquilizers).

To date, official medicine has the following interesting information about the duration of CFS. The average life expectancy of the disease is about 5-7 years, although the cases of CFS for more than 20 years have already been described. Such a prolonged existence of the disease is associated, perhaps, with an underestimation of the symptoms, with a lack of perception of one's condition as a disease, and also, which is a sin to conceal, with the illiteracy of medical personnel, often dismissing people with CFS.

Often the disease has an undulating course with periods of slight improvement in well-being. There are periods of partial or even complete remission, but almost always there are relapses. Constant fatigue does not allow a person to work, so up to 2/3 of all patients with such problems do not work at all or have part-time employment.

Diagnostics

CSU does not have any specific diagnostic test or examination. Domestic medicine generally rarely establishes such a diagnosis. And, nevertheless, if such a disease exists, let's try to understand the intricacies of its diagnosis.

In 1994, the clinical criteria for chronic fatigue syndrome were developed. According to them, for the diagnosis of CFS, 4 or more of the following 8 symptoms are necessary:

• memory impairment, ability to concentrate;
• pain when feeling the cervical or axillary lymph nodes;
• pain or sensation of muscle tension;
• pain in joints (without other signs of their defeat in the form of redness or swelling);
• the first headache or change in the characteristics of a pre-existing headache;
• unproductive sleep (without a sense of recovery);
• increasing fatigue until exhaustion after any physical or mental stress, lasting more than a day.

The next important step in the diagnosis of chronic fatigue syndrome is the exclusion of other diseases, the manifestation of which may be symptoms of CFS. For this purpose, an exhaustive examination of the patient is carried out (after all, the symptoms are so nonspecific and can serve as a manifestation of a huge number of somatic problems). The main studies include:

• a general blood test (including the definition of the leukocyte formula, ESR, platelets);
• biochemical indicators (liver and kidney tests, protein, glucose, calcium, sodium, potassium, alkaline phosphatase and others);
• general urine analysis;
• acute phase reactions (determination of C-reactive protein and rheumatoid factor);
• specific tests for infectious diseases (they are performed if the appearance of the symptoms of the patient is associated with the transferred infectious disease): examination for syphilis, viral hepatitis, herpes viruses, toxoplasmosis, chlamydia, candidiasis and so on. The HIV test is mandatory for every patient with complaints of constant fatigue;
• examination of the patient's hormonal background;
• electrocardiography;
• MRI (magnetic resonance imaging) of the brain;
• polysomnography (computer study of the period of sleep with simultaneous fixation of a set of indicators).

This is by no means the full range of possible surveys. Their list may be different, depending on the complaints of the individual patient (for example, in chronic cough, chest X-ray is necessary). It may be necessary to consult several specialists (otorhinolaryngologist, ophthalmologist, gastroenterologist, cardiologist, infectiologist, oncologist and others) to make sure that there is no organic cause of CFS. It can be said that the chronic fatigue syndrome is, rather, the diagnosis of an exception than the establishment of specific violations.

In addition to laboratory and instrumental research methods, patients are screened for cognitive and mental status. They are also offered to undergo special questionnaires developed for CFS (multidimensional fatigue questionnaire, a quality of life questionnaire, a McGill questionnaire for pain assessment, and a questionnaire for assessing sleep quality). Such a multifaceted and multidisciplinary study of the human body makes it possible to clarify the nature of the violations.

The result of the survey is as follows: in the absence of obvious signs of another disease and the presence of at least 4 clinical criteria out of 8 (from 1994), one can speak of the presence of CFS.

The syndrome of chronic fatigue is a relatively new formulation of health problems of modern man, connected with urbanization, accelerated pace of life. Humanity has existed for many centuries, but only the last 100 years are associated with a condition such as chronic fatigue syndrome. Although it is not yet a very common diagnosis of CFS, it is possible that in the future this problem will be given much more attention in connection with the increased incidence of treatment with this pathology.

The channel "Medicine of Israel", the program on the theme "Chronic fatigue syndrome":

Chronic fatigue syndrome. Chronic fatigue is a cure. Symptoms of chronic fatigue.

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