Bullones Rodríguez, María Ángeles, Afari, Niloofar, Buchwald, Dedra S et al. · The Journal of urology · 2013 · DOI
This study looked at how often people with unexplained urinary and bladder conditions also have other unexplained pain and fatigue conditions like fibromyalgia and ME/CFS. Researchers reviewed over 1,000 published studies and found that these conditions often occur together in the same person—sometimes up to 79% of people with chronic pelvic pain also had irritable bowel syndrome symptoms. This suggests these conditions may share common underlying causes rather than being completely separate diseases.
ME/CFS patients frequently experience comorbid unexplained conditions including urological and gastrointestinal symptoms. Understanding the extent and nature of these overlaps supports a systems-level perspective of ME/CFS pathophysiology rather than isolated organ dysfunction, potentially redirecting research toward common underlying biological mechanisms.
This review does not establish causation between conditions or identify specific biological mechanisms driving comorbidity. The substantial methodological heterogeneity across included studies means the reported comorbidity estimates should be viewed cautiously, and the findings reflect correlation rather than mechanistic understanding.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bullones Rodríguez, María Ángeles, Afari, Niloofar, Buchwald, Dedra S, & National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Urological Chronic Pelvic Pain (2013). Evidence for overlap between urological and nonurological unexplained clinical conditions.. The Journal of urology. https://doi.org/10.1016/j.juro.2012.11.019
BibTeX
@article{mecfsatlas-bullones-rodrguez-2013-evidence-overlap,
author = {Bullones Rodríguez, María Ángeles and Afari, Niloofar and Buchwald, Dedra S and National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Urological Chronic Pelvic Pain},
title = {Evidence for overlap between urological and nonurological unexplained clinical conditions.},
journal = {The Journal of urology},
year = {2013},
doi = {10.1016/j.juro.2012.11.019},
note = {PubMed: 23234637},
url = {https://www.mecfsatlas.com/evidence/bullones-rodrguez-2013-evidence-overlap},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/bullones-rodrguez-2013-evidence-overlap
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