New Finding: Increased Risk of Developing Peptic Ulcer Disease in Fibromyalgia Patients

Researchers from Taiwan found that patients with fibromyalgia are 1.4 times more susceptible to developing peptic ulcer disease (PUD) than those without the disease.


The correlation of fibromyalgia syndrome (FMS) with peptic ulcer disease (PUD) is unclear. We therefore conducted a cohort study to investigate whether FMS is correlated with an increased risk of PUD.


In this study, we established an FMS cohort comprising 26068 patients aged more than 20 years who were diagnosed with FMS from 2000 to 2011. Furthermore, we established a control cohort by randomly choosing 104269 people without FMS who were matched to the FMS patients by gender, age, and index year. All patients were free of PUD at the baseline. Cox proportional hazard regressions were performed to compute the hazard ratio of PUD after adjustment for demographic characteristics and comorbidities.


The prevalence of comorbidities was significantly higher in the FMS patients than in the controls. The incidence of PUD was 29.8 and 19.4 per 1000 person-years in the FMS and control cohorts, respectively. In addition, the FMS cohort exhibited a 1.40-fold higher risk of PUD (95% confidence interval = 1.35–1.45) compared with the control cohort. After control for confounding factors, the medications (selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, and antidepressants) taken by the FMS patients did not increase the risk of PUD.

About 50 percent of patients with fibromyalgia also have secondary illnesses, such as gastrointestinal disorders. Previous studies have associated fibromyalgia pain with specific foods or even small intestinal bacterial outgrowth. Although the underling mechanism that associating fibromyalgia with gastrointestinal disorders is still unclear, some researchers believe that they can have the same drivers.

Ulcers are often caused by a bacterium called Helicobacter pylori. Consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) has also been linked to the development of ulcers.

Researchers performed a nationwide study based on Taiwan’s National Health Insurance program to evaluate the association between fibromyalgia and the development of peptic ulcer disease. A total of 26,068 fibromyalgia patients and 104,269 controls were included in the study.

Fibromyalgia patients showed a higher incidence of secondary diseases such as diabetes, liver cirrhosis, hypertension, depression, and gastroesophageal reflux disease than the control group. NSAID use was also reported to be more higher in the fibromyalgia group than in the control group.

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The authors found a higher incidence of peptic ulcer disease in fibromyalgia patients — a 1.4-fold higher risk of PUD compared with the control group. Also, patients older than 50 were reported to have a 1.6-fold higher risk of developing peptic ulcer disease than younger people with fibromyalgia. Presence of secondary diseases was also associated with increased risk of PUD.

Patients undergoing fibromyalgia treatment showed 1.6 times increased risk of PUD development compared to 1.5 times of those not receiving treatment. This result was not significantly affected by the type of treatment received, suggesting that the drugs prescribed were not responsible for ulcer occurrence, the authors reported.

“In this study, we demonstrated that [fibromyalgia] contributes to an elevated risk of PUD,” the team wrote in its report. “Fibromyalgia patients had a high prevalence of comorbidities, and the drugs identified that relieve psychosomatic symptoms in [fibromyalgia] did not increase the likelihood of ulcers.”

More studies are needed to identify possible causes of the increased incidence of peptic ulcer disease in fibromyalgia patients.

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Written by Alice Maleo retrieved from Fibromyalgia News Today

The finding were recently published in the journal Plos One in a study titled “Association between fibromyalgia syndrome and peptic ulcer disease development.”

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One Comment

  1. I have been recently diagnosed with Fibromyalgia. In the past 5 years my health is declining rapidly. I cannot hike and workout the way I used to. All the things me and the family used to do..I’m left out. My migraines are so debilitating that I have “episodes” that leave me in pain for days in bed. NOTHING RELIEFS THESE EPISODES! My rhemoltologist even dismisses have of the things I go through on a daily basis! I don’t even think the Docs are educated enough in this chronic illness! Pain is constant. In on the verge of losing my job because of it.