Complex regional pain syndrome (CRPS) is known by a variety of different names like reflex sympathetic dystrophy (RSD), shoulder-hand syndrome, causalgia, reflex neurovascular dystrophy (RND), amplified musculoskeletal pain syndrome (AMPS) and Sudeck's atrophy.
Cause of the disorder is unknown and a variety of triggers have been identified.
Is It Leaky Gut or Leaky Gut Syndrome?
While type I like RSD does not have any obvious nerve damage, such a damage can be seen in type II or causalgia. Patients with CRPS/RSD have pain unrelated to issues involving chronic pain syndromes like fibromyalgia.
Leaky gut in CRPS/RSD
Dr. Goebel and colleagues examined intestinal permeability in patients with fibromyalgia using two sets of controls. They recruited not just healthy subjects but also patients with complex regional pain syndrome (CRPS) for comparison. The intestinal permeability or gut leakiness was increased in patients with fibromyalgia as they had hypothesized.
To their surprise, these investigators found that patients with unrelated pain disorder of CRPS also had increased gut leakiness as compared to healthy subjects and not different from patients with fibromyalgia.
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Intestinal bacteria in CRPS/RSD
Studies documenting alterations in intestinal bacterial pattern in CRPS (reduced diversity of bacteria) lend further credibility to the circumstantial evidence that gut is intimately involved in CRPS/RSD. Studies have suggested defective immune system involvement in causing and sustaining these diseases.
Dr. Minocha's comments
While direct smoking gun evidence is lacking, connecting the dots on the available circumstantial evidence implicates unhealthy/leaky gut in causation/perpetuation of RSD/CRPS. It is possible that the leaky gut allows for potentially toxic substances derived from diet or bacteria etc. from the gut lumen to pass through gut and interact with intestinal and extra-intestinal immune system as well as with nerve cells in gut contributing to the disorder.
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