Tsai, Shin-Yi, Chen, Hsuan-Ju, Lio, Chon-Fu et al. · Journal of translational medicine · 2019 · DOI
This study found that people with inflammatory bowel disease (IBD) are more than twice as likely to develop ME/CFS compared to people without IBD. The researchers looked at medical records from Taiwan and followed patients over time to see who developed ME/CFS. The increased risk was especially high in men and older adults with IBD who didn't have other chronic conditions.
This study provides population-level evidence that IBD and ME/CFS share a meaningful epidemiological relationship, suggesting potential shared mechanisms such as intestinal barrier dysfunction or immune dysregulation. Understanding this association could help clinicians recognize ME/CFS risk in IBD patients and guide future mechanistic research into gut-immune factors in ME/CFS pathogenesis.
This observational study cannot establish that IBD causes ME/CFS—only that they co-occur more frequently than expected. The association could reflect shared genetic susceptibility, common triggers, diagnostic bias, or reverse causation. The findings do not identify specific mechanisms linking these conditions or prove that treating IBD will prevent ME/CFS development.
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
Tsai, Shin-Yi, Chen, Hsuan-Ju, Lio, Chon-Fu, Kuo, Chien-Feng, Kao, An-Chun, Wang, Wei-Shieng, et al. (2019). Increased risk of chronic fatigue syndrome in patients with inflammatory bowel disease: a population-based retrospective cohort study.. Journal of translational medicine. https://doi.org/10.1186/s12967-019-1797-3
BibTeX
@article{mecfsatlas-tsai-2019-increased-risk,
author = {Tsai, Shin-Yi and Chen, Hsuan-Ju and Lio, Chon-Fu and Kuo, Chien-Feng and Kao, An-Chun and Wang, Wei-Shieng and Yao, Wei-Cheng and Chen, Chi and Yang, Tse-Yen},
title = {Increased risk of chronic fatigue syndrome in patients with inflammatory bowel disease: a population-based retrospective cohort study.},
journal = {Journal of translational medicine},
year = {2019},
doi = {10.1186/s12967-019-1797-3},
note = {PubMed: 30795765},
url = {https://www.mecfsatlas.com/evidence/tsai-2019-increased-risk},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tsai-2019-increased-risk
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