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The following is a summary of “Brain Fog in Gastrointestinal Disorders: Small Intestinal Bacterial Overgrowth, Gastroparesis, Irritable Bowel Syndrome,” published in the October 2024 issue of Gastroenterology by Halabi et al.       

Brain fog (BF), which includes memory difficulties and lack of mental clarity, has known associations with chronic fatigue syndrome, COVID-19, and increasingly with gastrointestinal (GI) issues such as small intestinal bacterial overgrowth (SIBO) and probiotic use.  

Researchers conducted a retrospective study investigating associations between BF, GI conditions, specific medications, and SIBO.  

They used a questionnaire approach, including the Patient Assessment of GI Disorders Symptom Severity Index (PAGI-SYM) and a Brain Fog Questionnaire (BFQ; 20 symptoms scored from never=0 to always=4, for a total score of 0 to 80), completed by 102 patients undergoing lactulose breath testing (LBT) for clinical SIBO assessment. The demographic survey included BF symptoms and medication use (e.g., probiotics, proton pump inhibitors [PPIs]).  

The results showed that 54% (55 of 102) of participants reported BF, with significantly higher BFQ scores in those experiencing BF than those without [38.2±15.6 vs. 10.9±9.4 (SEM) (P=0.001)]. Patients with BF were more likely to use probiotics and PPIs than those without (P=0.04). No notable differences in narcotic, prokinetic, or prebiotic use were observed, BF prevalence was higher in those with gastroparesis and irritable bowel syndrome (IBS) (P=0.01 and 0.05, respectively), though no significant difference was found for SIBO or intestinal methanogen overgrowth (IMO).  

They concluded that BF was common among patients with GI disorders and appears more prevalent in those with gastroparesis, IBS, and probiotic use. The BFQ may help diagnose and assess BF severity.  

Source: journals.lww.com/jcge/abstract/9900/brain_fog_in_gastrointestinal_disorders__small.369.aspx