CP/CPPS and CFS, IBS and Fibromyalgia

Many men with chronic pelvic pain report symptoms of CFS, IBS and Fibromyalgia. Is there a connection?

Note: CFS = Chronic Fatigue Syndrome, IBS = Irritable Bowel Syndrome, Fibro = Fibromyalgia.

Many Patients have reported a CFS-like illness at or near the onset of their CP/CPPS. Recent studies have shown that CFS is indeed linked to chronic prostatitis. In general, studies have found that there is an association between urologic chronic pelvic pain syndromes (CPPS and IC) with conditions like chronic fatigue, fibromyalgia, irritable bowel syndrome, multiple chemical sensitivities, and temporomandibular disorder.

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS), also sometimes called myalgic encephalomyelitis (ME) in Europe, is defined as unexplained chronic fatigue that lasts for more than six months, impairs normal activities and has no identifiable medical or psychological problems to account for it.

Four or more of the following symptoms must have been present for longer than six months:

  1. short-term memory loss or a severe inability to concentrate that affects work, school, or other normal activities
  2. sore throat
  3. swollen lymph nodes (eg. in the neck or armpits)
  4. muscle pain
  5. pain without redness or swelling in a number of joints
  6. intense or changing patterns of headaches
  7. unrefreshing sleep
  8. after any exertion, weariness that lasts for more than a day

The fatigue must be severe: sleep or rest does not relieve it; the fatigue is not the result of excessive work or exercise; the fatigue substantially impairs a person’s ability to function normally at home, at work, and in social occasions. Even mild exercise often makes the symptoms, especially fatigue, much worse.

Irritable Bowel Syndrome

Symptoms of irritable bowel syndrome (IBS) include abdominal pain, mucus in the stools, and alternating diarrhoea and constipation. Other terms for irritable bowel syndrome include ‘spastic colon’ and ‘irritable colon’. Some of the more common signs of irritable bowel syndrome include:

  1. Abdominal pain or cramping that is often relieved by passing wind or faeces
  2. Alternating diarrhoea and constipation
  3. A sensation that the bowels are not fully emptied after passing a motion
  4. Abdominal bloating
  5. Mucus present in the stools
  6. Nausea

Irritable bowel syndrome can be subdivided into three major categories:

  1. Constipation-predominant – the person tends to alternate constipation with normal stools. Symptoms of abdominal cramping or aching are commonly triggered by eating.
  2. Diarrhoea-predominant – the person tends to experience diarrhoea first thing in the morning or after eating. The need to go to the toilet is typically urgent and cannot be delayed. Incontinence may be a problem.
  3. Alternating constipation and diarrhoea.

Note: recent studies have shown a link between IBS and certain sugars, and it is possible to cure yourself of IBS following a special diet.


Fibromyalgia is a condition in which people describe symptoms that include widespread pain and tenderness in the body, often accompanied by fatigue, cognitive disturbance and emotional distress. The most common symptoms are:

  1. increased sensitivity to pain due to a decreased pain threshold
  2. increased responsiveness to sensory stimuli such as heat, cold, light and numbness or tingling
  3. extreme fatigue (tiredness)
  4. problems with cognition (impacting on memory and concentration)
  5. problems with sleep

Symptoms can be mild, moderate or severe. Symptoms may disappear for extended periods of time, perhaps even years. Some people with fibromyalgia have other symptoms, such as irritable bowel syndrome, irritable or overactive bladder, headaches, and swelling and numbness or tingling in the arms and legs. Living with ongoing pain and fatigue often leads to secondary problems such as anxiety and depression.

Symptoms similar in CFS, temporomandibular disorder and fibromyalgia

By Elda Hauschildt

CHICAGO: There is now preliminary evidence that patients with chronic fatigue syndrome, fibromyalgia and temporomandibular disorder share the same key symptoms.

These symptoms include generalized pain sensitivity, sleep and concentration difficulties, bowel complaints, and headache. Researchers also say it is apparent that seven other localized and systemic illnesses may occur at the same time as the three conditions.

These include chronic tension-type headache, irritable bowel syndrome, bladder pain syndrome/interstitial cystitis (BPS/IC), post-concussive syndrome, multiple chemical sensitivities, chronic pelvic pain and chronic low back pain.

Seattle researchers recruited 25 chronic fatigue patients, 22 fibromyalgia patients and 25 temporomandibular patients from hospital- based clinics. All of the patients were diagnosed by their physicians. The control group numbered 22 healthy subjects from a dermatology clinic.

All participants completed a 138-item symptom checklist. They then underwent brief physical examinations.

Most patients reported few past diagnoses of the 10 clinical conditions outside of their primary diagnosis. Patients diagnosed with each of the three main conditions were more likely than control subjects to meet lifetime symptom and diagnostic criteria for many of the other conditions.

The most striking finding was that of lifetime rates of irritable bowel syndrome. Researchers found the syndrome in 92 per cent of chronic fatigue, 77 per cent of fibromyalgia, and 64 per cent of temporomandibular disorder patients.

Archives of Internal Medicine, 2000; 160: 221-227