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Primary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process
D Veale1, G Kavanagh, J F Fielding
1Department of Rheumatology, Beaumont Hospital, Dublin, Ireland.
Abstract:
Primary fibromyalgia (PFM) and the irritable bowel syndrome (IBS) are both common conditions which account for 30% or more of referrals to rheumatology and gastroenterology clinics. An association between symptoms in PFM and IBS has been suggested but the frequency with which they coexist has not been assessed. The aim of this study was to examine the prevalence of each condition in groups of patients with PFM and IBS compared to normal and disease control populations. We studied four patient groups, 20 patients in each group, with PFM, IBS, inflammatory arthritis, inflammatory bowel disease and also 20 normal controls. Using strict diagnostic criteria, each group was assessed by two investigators for symptoms and signs of PFM and IBS. Sigmoidoscopy was performed when indicated. Results indicate that 70% (14/20) of the PFM patients had IBS and 65% (13/20) of the IBS patients had PFM. This compared with the control groups where 12% (7/60) and 10% (6/60) had PFM and IBS respectively. In conclusion, these results indicate that PFM and IBS frequently coexist. A common pathogenetic mechanism for both conditions is therefore suggested.
Insights
Primary fibromyalgia (PFM) and irritable bowel syndrome (IBS) frequently coexist. This study suggests a shared underlying cause for these common conditions, impacting patient referrals.
Area of Science:
- Rheumatology and Gastroenterology
- Clinical Medicine
- Symptomology and Disease Coexistence
Background:
- Primary fibromyalgia (PFM) and irritable bowel syndrome (IBS) are prevalent conditions, frequently leading to specialist clinic referrals.
- Previous suggestions of an association between PFM and IBS symptoms lack quantitative assessment of their coexistence.
- Understanding the comorbidity of PFM and IBS is crucial for patient management and research.
Purpose of the Study:
- To determine the prevalence of PFM in IBS patients and IBS in PFM patients.
- To compare the comorbidity rates of PFM and IBS in patient groups versus control populations.
- To investigate potential shared pathogenetic mechanisms underlying PFM and IBS.
Main Methods:
- Four patient groups (20 each) were studied: PFM, IBS, inflammatory arthritis, and inflammatory bowel disease.
- A control group of 20 healthy individuals was included for comparison.
- Strict diagnostic criteria and investigator assessments were used for PFM and IBS symptoms; sigmoidoscopy was performed as indicated.
Main Results:
- A high comorbidity rate was observed: 70% of PFM patients exhibited IBS symptoms, and 65% of IBS patients had PFM.
- Control groups showed significantly lower rates: 12% had PFM and 10% had IBS.
- These findings highlight a strong association between PFM and IBS.
Conclusions:
- Primary fibromyalgia and irritable bowel syndrome frequently coexist in patients.
- The high rate of comorbidity suggests a potential common pathogenetic mechanism for both conditions.
- Further research into shared etiologies is warranted to improve understanding and treatment.