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Fibromyalgia in inflammatory bowel disease
D Buskila1, L R Odes, L Neumann
1Department of Internal Medicine B, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
The Journal of Rheumatology
|May 20, 1999
Summary
Fibromyalgia (FM) is common in inflammatory bowel disease (IBD), especially Crohn's disease (CD). Patients with CD have lower pain thresholds, suggesting a disease-specific effect needing correct diagnosis and treatment.
Area of Science:
- Rheumatology
- Gastroenterology
- Pain Medicine
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is often associated with rheumatological complications.
- While peripheral arthritis and spondylitis are well-studied, soft tissue rheumatism, specifically fibromyalgia syndrome (FM), remains less understood in IBD patients.
Purpose of the Study:
- To determine the prevalence of fibromyalgia syndrome (FM) in patients diagnosed with inflammatory bowel disease (IBD).
- To assess and compare pain and tenderness thresholds in patients with Crohn's disease (CD) and ulcerative colitis (UC) compared to healthy controls.
Main Methods:
- A cohort of 113 patients with IBD (72 UC, 41 CD) and 120 healthy controls were evaluated.
- Fibromyalgia syndrome (FM) diagnosis was based on the 1990 American College of Rheumatology criteria.
- Tenderness thresholds were measured using manual palpation and a dolorimeter.
Main Results:
- Fibromyalgia syndrome (FM) was diagnosed in 30% of IBD patients (49% of CD patients, 19% of UC patients), versus 0% in controls (p=0.001).
- Patients with CD exhibited significantly higher tenderness (11.3 tender points) and lower pain thresholds (2.9 kg) compared to UC patients (6.4 tender points, 3.9 kg) and controls (0.1 tender points, 5.8 kg).
- CD patients reported more frequent and severe FM-associated symptoms.
Conclusions:
- Fibromyalgia syndrome (FM) is a prevalent comorbidity in inflammatory bowel disease (IBD), with a notably higher incidence in Crohn's disease (CD).
- The diminished pain threshold observed in CD patients may indicate a specific pathophysiological link between CD and FM.
- Early recognition and appropriate management of FM in IBD patients are crucial to prevent misdiagnosis and ensure effective treatment strategies.