Researchers studied 42 children ages 8 to 17 with IBS who were given either a capsule containing peppermint oil or placebo.

After two weeks, the children reported a dramatic reduction in pain, which was measured using rating tools such as the Gastrointestinal Symptom Rating Scale and daily diaries. Three-quarters (76%) of the children who received peppermint capsules reported improvement in pain but only 19% of the children who received a placebo reported improvement.

Other clinical studies have shown that peppermint oil can relax the lower esophageal sphincter and relieve symptoms of dyspepsia and colon spasms. Researchers suggest that clinicians consider using peppermint oil to treat moderate pain in children with IBS. However, they caution that although none of the children in their study experienced any adverse side effects, previous study participants taking peppermint oil experienced a few side effects, such as mild rectal burning and heartburn.

Patients with vascular syncope studied for CFS
In a February 2001 article in the American Journal of Medicine, researchers with the Royal Victoria Infirmary in Newcastle investigated whether patients with a primary diagnosis of vasovagal syncope also had CFS.

Sixty-two patients underwent a head-up tilt-table test and examination and then completed a semi-structured questionnaire for CFS. The study revealed that 21% of the patients met CFS criteria but none of the 119 healthy controls did.

In addition, almost a quarter of the patients with vasovagal syncope who did not meet the CFS case definition criteria still had a high prevalence of CFS symptoms, such as sleep disturbance, sore throat, myalgia, and fatigue.

The study raises the possibility that CFS and vasovagal syncope may share a common pathophysiology.

Role of mononucleosis in chronic illnesses
Researchers at the University of Washington studied how often acute mononucleosis precipitates chronic illness and attempted to describe the psychosocial, clinical, and demographic features that characterize patients who report no recovery.

The study examined 150 patients with infectious mononucleosis and asked them to assess their recovery at two and six months. Self-assessed failure to recover was reported by 38% of patients at two months and by 12% at six months.

Those who had not recovered reported a persistent illness characterized by fatigue and poor functional status. They also reported poorer general health and worse pain. Patients then underwent physical examinations and laboratory tests, but no disease was diagnosed.

The study, published in the American Journal of Medicine (November 2000), suggests that some patients with viral infections do not fully recover and that persistent illness is characterized by fatigue and impaired functional status.

The researchers said that those patients who did not recover resemble patients with CFS, supporting the theory that chronic fatigue syndrome follows certain infections.

CFS memory deficits
Researchers from the University of Alberta, Canada, have found further evidence of neurocognitive impairments in CFS patients.

The performance of 20 CFS patients on four tests of working memory was compared to that of 20 healthy controls. Tests assessed the ability to remember a series of numbers, remember facts when given a time deadline, and sustain attention to memorization tasks when distracted.

The CFS patients’ memory deficits compared to controls were most prominent during demanding tasks that required heavy concentration and the ability to efficiently switch between different types of information processing.

Results of the study were published in the March 2001 issue of the Journal of International Neuropsychology.

Subset of patients with Sjogren’s
Many CFS patients have coexisting conditions. A study published in the January 2001 issue of the Journal of Rheumatology shows that a subset of CFS patients may have Sjogren’s syndrome, an autoimmune disorder that can cause joint aches and dry eyes and mouth.

Researchers from the University of Medicine and Dentistry of New Jersey-New Jersey Medical School tested 25 patients and 18 healthy controls for Sjogren’s using salivary gland biopsies, tear production tests, and blood tests for antinuclear antibodies.

None of the controls met the diagnostic criteria for Sjogren’s, but eight of the CFS patients did. The researchers concluded that a small subset of patients with CFS may have primary Sjogren’s syndrome.

Doctor-patient perspectives on CFS
A study that looked out how general practitioners (GPs) diagnose chronic fatigue syndrome (CFS) and what they think of their patients was reported on in The Journal of Chronic Fatigue Syndrome (Vol. 7, #4; 2001).

The study polled 120 general practitioners (GPs) on how frequently they diagnosed CFS, the causes and attributions of patients’ complaints, patients’ expectations, and their opinion on communicating with CFS patients.

Two hundred and eleven CFS patients were then asked the same questions and the results were compared.

When asked to compare their relationships with their CFS patients to other patients, 89% of the GPs responded that CFS patients took more time, 73% believed their CFS patients regularly caused problems, 43% reported communication problems, and 31% rated contact and cooperation as poor.

About half of the physicians reported less empathy for CFS patients as compared to other patients. More than half of the CFS patients said medical specialists did not take their complaints seriously and did not sympathize with them.

The study also showed a large discrepancy between what GPs and patients believe the cause of CFS to be. Most patients attributed their symptoms to physical factors while most physicians attributed complaints to psychological factors.

The study showed a mere 10% of the practitioners felt they knew enough about CFS to advise their patients and only half of the GPs reported using the CFS diagnosis, primarily because they were unfamiliar with the criteria (69%). About 20% did not think CFS was a legitimate illness.

The lack of knowledge about the condition underscores the need to develop specific guidelines for health care practitioners to identify and manage CFS.

Keep in mind that research studies with fewer than 500 patients are generally not considered statistically valid and may be questioned by the medical community. The Chronicle reports on smaller studies due to the lack of large-scale research projects and to keep you updated on emerging trends.