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Fibromyalgia: the gastrointestinal link
Daniel J Wallace1, David S Hallegua
1Cedars-Sinai/UCLA School of Medicine, 8737 Beverly Blvd., Suite 203, Los Angeles, CA 90048, USA. dwallace@ucla.edu
Current Pain and Headache Reports
|September 14, 2004
Summary
Fibromyalgia (FM) patients often experience gastrointestinal issues. Small intestinal bacterial overgrowth is common in FM, causing pain and IBS-like symptoms, and may improve with antibiotics.
Area of Science:
- Gastroenterology
- Rheumatology
- Clinical Medicine
Background:
- Fibromyalgia (FM) is frequently accompanied by gastrointestinal (GI) symptoms.
- The relationship between FM and various GI disorders requires clarification.
Purpose of the Study:
- To critically review the literature on the association between fibromyalgia and gastrointestinal disorders.
- To elucidate the complex interplay between FM, irritable bowel syndrome (IBS), and other GI conditions.
Main Methods:
- Literature review of existing studies on FM and GI symptoms.
- Analysis of evidence regarding inflammatory bowel disease, celiac disease, reflux, dyspepsia, and small intestinal bacterial overgrowth in FM patients.
Main Results:
- Evidence linking FM and inflammatory bowel disease is contradictory.
- Celiac disease is often diagnosed in patients with a history of FM or IBS.
- Gastroesophageal reflux, nonulcer dyspepsia, noncardiac chest pain, and IBS are prevalent in FM patients.
- Small intestinal bacterial overgrowth (SIBO) is common in FM, associated with hyperalgesia and IBS-like symptoms, and shows transient response to antibiotics.
Conclusions:
- GI disorders are common in fibromyalgia patients, complicating management.
- IBS affects 30-70% of FM patients, involving smooth muscle and parasympathetic nervous system dysfunction.
- SIBO is a significant factor in FM, contributing to pain and IBS-like symptoms.