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Prevalence of Functional Gastrointestinal Disorders in Patients With Fibromyalgia

Fibromyalgia is a rheumatologic disorder associated with somatic and psychologic conditions. Although fibromyalgia is associated with irritable bowel syndrome, its relationship with other functional gastrointestinal disorders (FGID) is unclear. We evaluated the prevalence of FGID in patients with fibromyalgia and the role of psychologic factors in this relationship.

Fibromyalgia isn’t easy on the gut either! There are various gastrointestinal related symptoms, including nausea, Irritable Bowel Syndrome (IBS), abdominal pain, slow digestion and constipation. These symptoms – as you can well imagine – can be extremely uncomfortable. For those of us already dealing with pain and fatigue these gastrointestinal symptoms make it even more difficult to function normally. They can affect all aspects of our lives, from careers to friendships to family relationships.

Gastrointestinal Problems are the problems effecting your stomach, colon, intestines and esophagus and can manifest as many different illnesses: from Gastric Reflux Syndrome to  Irritable Bowell Symptom, to generalized bloating to generalized gas or any type of pain in the stomach, colon or intestine.  You might have chronic diarrhea or chronic constipation.Lastly you might experience one of these problems, many of these problems or all of these problems.

You have had all kinds of examinations from Endoscopies, to upper and lower GI studies to MRI’s and the diagnoses are the same as the above.

The pain can occur immediately after eating or hours later. With some, the pain is constantly present. You can try different types of food, different diets and different supplements but you cannot really stop these problems, you might make them decrease a bit but the GI problems still remain. So what the heck is going on?

The results of the study, conducted in Spain, showed that 98 percent of the FM patients had some kind of GI problem.   That doesn’t surprise me at all.   It also showed that the FM patients had higher scores of psychologic distress than the healthy controls.   That also doesn’t surprise me.   I’d venture to say that almost everyone who lives with a chronic painful illness of any kind has some degree of psychologic distress – certainly more than someone who is perfectly healthy.

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From this, the researchers concluded that the increased psychologic distress in FM patients predisposed them to GI disorders.   Here’s where I have a big problem.   There are several other possible causes for the GI problems that were not included in the study or even considered.   Two that immediately come to mind are:

  • Fibromyalgia is a central nervous system disorder that causes hypersensitivity.   Not only are we hypersensitive to pain, we’re also often hypersensitive to medications, chemicals, light, sound, etc.   It seems reasonable to think there’s a good chance our digestive systems may also be hypersensitive, which could result in a variety of GI disorders.
  • Many of the medications we take have side effects that affect our digestive systems.   I did a quick check of the most commonly prescribed medications for FM and every single one listed one or more of the following adverse reactions: nausea, vomitting, constipation, diarrhea – all GI disorders.

Until and unless these other factors are taken into consideration, I don’t think we can jump to any conclusions about the impact of psychologic distress on GI disorders and fibromyalgia.

Frankly, I’m sick and tired of continuing to see precious research dollars being wasted on poorly constructed studies designed to link fibromyalgia to psychological problems.   It’s time researchers stopped beating that dead horse and started trying to find better treatments for us.   I’d even venture to say that if they could find a way to relieve the pain and fatigue, whatever psychologic distress we might have would go away as well.

Result

Ninety-three percent of the total study population was female, with a mean age of 50 years. We identified 6 cases of widespread pain among controls. The average Fibromyalgia Impact Questionnaire score for patients was 67.28 ± 14.25. All gastrointestinal symptoms except for vomiting were more frequent in patients. Ninety-eight percent of patients with fibromyalgia had at least one FGID, compared with only 39% of controls. Fibromyalgia was correlated most highly with irritable bowel syndrome. Patients presented with significantly higher scores of psychologic distress than controls, especially those with fecal incontinence.


Source:   Almansa, Cristina, et al (2009, April). Prevalence of Functional Gastrointestinal Disorders in Patients With Fibromyalgia and the Role of Psychologic Distress. Clinical Gastroenterology and Hepatology, Volume 7, Issue 4.

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