Background The etiopathogenesis of Fibromyalgia Syndrome (FMS) still remains unclear. Helicobacter Pylori (HP) has been implicated as playing a role in a variety of extragastric diseases including FMS. However, studies on the association of HP and FMS are in limited number (1).
Objectives We have aimed to investigate the difference between HP infected and not infected patients for the presence of FMS to explore possibility of a link between HP infection and FMS.
Methods After obtaining Ethic Committe approval of our Institution, patients who presented to Gastroenterology Unit and tested HP as a part of their work-up were also referred to Rheumatology. At the same day of Gastroscopy, patients were evaluated by the same Rheumatologist. Patients with serious internal or psychiatric diseases or taking medications that would interfere with FMS symptoms were excluded. Patients indicated painful or tender areas that present over the last week according to widespread pain index (WPI) of 2010 modified FMS Diagnostic Criteria (2). If 3 or more areas were indicated, patients were further evaluated for the presence of FMS. Patients who were diagnosed FMS based on 2010 Diagnostic Criteria were also evaluated according to 1990 FMS Classification Criteria (3). Physical examinations and laboratory work-up were done to exclude conditions that would cause widespread pain. HP was tested with rapid urease test-HelicotecUT Plus, and biopsy specimens were obtained from antrum and the body of stomach (2 from each sites). Test reading were done up to 24 hours. Statistics: Quantitative data are expressed as means and standard deviations, and for the comparison of variables between groups, Student's t test was used. For the comparison of qualitative data, Pearson's chi-square test, Fisher's exact test and the Continuity Correction (Yates) test were used. P values <0.05 were considered as statistically significant.
Results We studied 95 cases; 53 (55.8%)HP positive and 42 (44.2%) HP negative. The age of patients ranged between 18 and 65 years, mean age 36.16±11.62 years. 51 patients (53.7%) were males and 44 (46.3%) were female. In 53 cases (55.8%), pain was indicated at least in one area of WPI. There was no statistically significant difference for the age between HP positive and negative patients (p=063). HP positivity in men (68.6%) was significantly higher than women (40.9%) (p=0.012). FMS was diagnosed in 6 cases (6.3%); 2 (3.8%) of HP positive patients and 4 (% 9.5) of HP negative patients, and the difference was not statistically significant (p=0.4).
Conclusions In a group of HP infected patients, we could not find higher rate of FMS compared to not infected patients. Our findings do not give any clue for an association between HP infection and FMS.
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Wolfe F, Smythe HA, Yunus MB et al. The American college of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 1990;33:160–72.
Disclosure of Interest None declared