Fragkos, Konstantinos C, Barragry, John, Fernando, Charisma Shahi et al. · Zeitschrift fur Gastroenterologie · 2018 · DOI
This case report describes one young woman with ME/CFS and chronic pain who developed severe inflammation in her colon (eosinophilic colitis) after taking two common pain medications—gabapentin and pregabalin. Her symptoms improved when she stopped the medications and received steroid treatment. This is an extremely rare side effect, but doctors should be aware of it if ME/CFS patients taking these drugs develop abdominal pain, diarrhea, and blood cell changes.
Many ME/CFS patients use gabapentin or pregabalin for pain and neurological symptoms, making awareness of this rare but serious adverse effect clinically important. This case report expands the known safety profile of these commonly prescribed medications in the ME/CFS population and highlights the need for gastrointestinal symptom monitoring during neuropathic pain treatment.
This single case report cannot establish causation or determine the incidence of eosinophilic colitis from these medications in the broader ME/CFS population. It does not explain the underlying mechanism of this adverse reaction or identify which patients are at highest risk. The temporal association observed does not prove gabapentin or pregabalin causes eosinophilic colitis in all or most patients.
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
Fragkos, Konstantinos C, Barragry, John, Fernando, Charisma Shahi, Novelli, Marco, Begent, Joanna, & Zárate-Lopez, Natalia (2018). Severe eosinophilic colitis caused by neuropathic agents in a patient with chronic fatigue syndrome and functional abdominal pain: case report and review of the literature.. Zeitschrift fur Gastroenterologie. https://doi.org/10.1055/a-0596-7981
BibTeX
@article{mecfsatlas-fragkos-2018-severe-eosinophilic,
author = {Fragkos, Konstantinos C and Barragry, John and Fernando, Charisma Shahi and Novelli, Marco and Begent, Joanna and Zárate-Lopez, Natalia},
title = {Severe eosinophilic colitis caused by neuropathic agents in a patient with chronic fatigue syndrome and functional abdominal pain: case report and review of the literature.},
journal = {Zeitschrift fur Gastroenterologie},
year = {2018},
doi = {10.1055/a-0596-7981},
note = {PubMed: 29890559},
url = {https://www.mecfsatlas.com/evidence/fragkos-2018-severe-eosinophilic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/fragkos-2018-severe-eosinophilic
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