Estimates suggest that anywhere from 30% to 70% of patients with fibromyalgia also suffer from irritable bowel syndrome (IBS), a chronic condition characterized by indigestion, irregularity, abdominal cramps, and diarrhea.1-3 Conversely, it's been estimated that about one in every five patients with IBS or even more, say some studies- has fibromyalgia.3,4

Whatever the exact number, it's clear that these two conditions often overlap. It's also clear that when they do overlap, symptoms associated with each condition are often much more severe than when they occur independently.

One recent study reported that IBS patients with fibromyalgia had much more severe intestinal symptoms compared to IBS patients without fibromyalgia.4 Another study found that when analyzed using the functional bowel disorder severity index, patients with both fibromyalgia and IBS had average scores that were 38% higher (indicating increased severity) than patients with IBS alone.5 Moreover, as many as half of fibromyalgia patients feel their bowel complaints are worse during exacerbations of joint disease.6

Similarly, having IBS seems to exacerbate symptoms of fibromyalgia. Patients with both conditions are more sensitive to pain, having lower pain thresholds and higher pain frequency and severity.7 Patients with fibromyalgia and IBS are also reported to have a significantly worse quality of life, based on objective indices, than patients with either disorder alone.3

For these reasons, many researchers emphasize that "patients with fibromyalgia have a high prevalence of gastrointestinal complaints that should be carefully assessed. If the diagnosis of IBS is confirmed, appropriate treatment may improve patients' symptoms."6

The following gastrointestinal assessments are important clinical tools to accurately assess and treat digestive dysfunctions that can underlie IBS:

The Comprehensive Digestive Stool Analysis (CDSA) evaluates digestion, absorption, intestinal function and microbial flora, possibly revealing fundamental causes and contributing factors involved in gastrointestinal distress accompanying fibromyalgia.

The Lactose Intolerance Breath Test can detect a very common cause of irritable bowel syndrome-lactose intolerance due to lactase deficiency, which is estimated to affect over 50 million Americans.

Bacterial Overgrowth of the Small Intestine Breath Test pinpoints one of the leading causes of unexplained intestinal symptoms associated with irritable bowel.

References:
1 Veale D, Kavanagh G, Fielding JF, Fitzgerald O. Primary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process. Br J Rheumatol 1991 Jun;30(3):220-222.

2 Sivri A, Cindas A, Dincer F, Sivri B.Bowel dysfunction and irritable bowel syndrome in fibromyalgia patients. Clin Rheumatol 1996 May;15(3):283-286.

3 Sperber AD, Atzmon Y, Neumann L, Weisberg I, Shalit Y, Abu-Shakrah M, Fich A, Buskila D. Fibromyalgia in the irritable bowel syndrome: studies of prevalence and clinical implications. Am J Gastroenterol 1999 Dec;94(12):3541-3546.

4 Lubrano E, Iovino P, Tremolaterra F, Parsons WJ, Ciacci C, Mazzacca G. Fibromyalgia in patients with irritable bowel syndrome. An association with the severity of the intestinal disorder.Int J Colorectal Dis 2001 Aug;16(4):211-215.

5 Sperber AD, Carmel S, Atzmon Y, Weisberg I, Shalit Y, Neumann L, Fich A, Friger M, Buskila D. Use of the Functional Bowel Disorder Severity Index (FBDSI) in a study of patients with the irritable bowel syndrome and fibromyalgia. Am J Gastroenterol 2000 Apr;95(4):995-998.

6 Triadafilopoulos G, Simms RW, Goldenberg DL. Bowel dysfunction in fibromyalgia syndrome. Dig Dis Sci 1991;36(1):59-64.

7 Chang L, Mayer EA, Johnson T, FitzGerald LZ, Naliboff B. Differences in somatic perception in female patients with irritable bowel syndrome with and without fibromyalgia. Pain 2000 Feb;84(2-3):297-307. 7 Triadafilopoulos G, Simms RW, Goldenberg DL. Bowel dysfunction in fibromyalgia syndrome. Dig Dis Sci 1991;36(1):59-64.


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