Stallmach, Andreas, Quickert, Stefanie, Puta, Christian et al. · Frontiers in immunology · 2024 · DOI
This review examines whether changes in gut bacteria might play a role in ME/CFS, particularly in cases that develop after infections like COVID-19. The authors found that many ME/CFS patients do show differences in their gut bacteria compared to healthy people, and these changes might trigger immune and inflammatory problems. However, the review concludes that current research hasn't proven that gut bacteria changes actually cause ME/CFS—only that they often occur together.
Understanding whether gut microbiota changes contribute to ME/CFS could identify new therapeutic targets for this debilitating condition lacking approved treatments. If dysbiosis is causally implicated, microbiota-modulating interventions (prebiotics, probiotics, dietary modifications) could potentially become evidence-based treatment options, offering hope to patients currently managing symptoms without specific medical therapies.
This review does not establish that gut microbiota changes cause ME/CFS—only that associations exist in some patient populations. The authors specifically highlight that current evidence cannot distinguish between dysbiosis as a primary driver versus a consequence of ME/CFS pathology or illness-related behavioral changes. The heterogeneous study populations and poorly defined patient cohorts limit any definitive conclusions about causality.
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
Stallmach, Andreas, Quickert, Stefanie, Puta, Christian, & Reuken, Philipp A (2024). The gastrointestinal microbiota in the development of ME/CFS: a critical view and potential perspectives.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2024.1352744
BibTeX
@article{mecfsatlas-stallmach-2024-gastrointestinal-microbiota,
author = {Stallmach, Andreas and Quickert, Stefanie and Puta, Christian and Reuken, Philipp A},
title = {The gastrointestinal microbiota in the development of ME/CFS: a critical view and potential perspectives.},
journal = {Frontiers in immunology},
year = {2024},
doi = {10.3389/fimmu.2024.1352744},
note = {PubMed: 38605969},
url = {https://www.mecfsatlas.com/evidence/stallmach-2024-gastrointestinal-microbiota},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/stallmach-2024-gastrointestinal-microbiota
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