Abstract
Fibromyalgia and irritable bowel syndrome frequently coexist. In this study, we utilized a previously validated self-administered questionnaire to assess the prevalence of symptoms of bowel dysfunction and irritable bowel syndrome in 123 patients with fibromyalgia as compared to 54 patients with degenerative joint disease (DJD) and 46 normal controls. Ninety (73%) of the fibromyalgia patients reported altered bowel function as compared to 20 (37%) DJD patients and none of the normal controls (P<0.001). Ninety-nine patients (81%) reported normal alternating with irregular bowel pattern, and 77 (63%) had alternating diarrhea and constipation. In contrast, only 24 (44%) of DJD patients and six (13%) of controls had regular alternating with irregular bowel pattern and only 12 (22%) of the DJD patients and none of the healthy controls had alternating constipation and diarrhea (P<0.001). Other bowel dysfunction complaints noted in the fibromyalgia group were abdominal gas (59%), nausea (21%), diarrhea (9%), and constipation (12%). Seventy-nine (64%) fibromyalgia patients reported frequent abdominal pain that was stress-related 47% of the time. Laxative use was frequent in the fibromyalgia group (19%) and absent in the other two groups. Fifty percent of fibromyalgia patients, compared to 28% of DJD patients, felt that their bowel complaints were worse during exacerbations of their joint disease (P<0.05). In conclusion, 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, although this approach requires further study.
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References
Bennett RM (ed): The fibrositis/fibromyalgia syndrome: Current issues and perspectives. Am J Med 81:1–115, 1986
Goldenberg DL: Fibromyalgia syndrome: An emerging but controversial condition. JAMA 257:2782–2787, 1987
Switz DM: What the gastroenterologist does all day. Gastroenterology 70:1048–1050, 1976
Drossman DA, Powell DW, Sessions JT Jr: The irritable bowel syndrome. Gastroenterology 73:811–822, 1977
Drossman DA, Sandler RS, McKee DC, Lovitz AJ: Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 83:529–534, 1982
Yunus M, Masi AT, Calabro JJ, Miller KA, Feigenbaum SL: Primary fibromyalgia (fibrositis) Semin Arthritis Rheum 11:151–171, 1981
Bengtsson A, Henriksson KG, Jorfeldt L, Kagedal B, Lennmarken C, Lindstrom F: Primary fibromyalgia. A clinical and laboratory study of 55 patients. Scand J Rheumatol 15:340–347, 1986
Campbell SM, Clark S, Tindall EA, Forehand ME, Bennett RM: Clinical characteristics of fibrositis. A blinded controlled study of symptoms and tender points. Arthritis Rheum 26:817–825, 1983
Romano TJ: Coexistence of irritable bowel syndrome and fibromyalgia. W Va Med J 84:16–18, 1988
Smythe H: Tender points: Evolution of concepts of fibrositis/fibromyalgia syndrome. Am J Med 81 (suppl 3A):2–6, 1986
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 33:160–172, 1990
Manning AP, Thompson WG, Heaton KW, Morris AF: Towards a positive diagnosis of the irritable bowel. Br Med J 2:653–654, 1978
Thompson WG, Heaton KW: Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288, 1980
Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ: Variation of bowel habits in 2 population samples. Br Med J 2:1095–1099, 1965
Wolfe F: The clinical syndrome of fibrositis. Am J Med 81 (suppl 3A):7–14, 1986
Kruis W, Thieme C, Weinzierl M, Schussler P, Holl J, Paulus W: A diagnostic score for the irritable bowel syndrome. Gastroenterology 87:1–7, 1984
Sandler RS, Drossman DA, Nathan HP, McKee DC: Symptom complaints and health care seeking behavior in subjects with bowel dysfunction. Gastroenterology 87:314–318, 1984
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Triadafilopoulos, G., Simms, R.W. & Goldenberg, D.L. Bowel dysfunction in fibromyalgia syndrome. Digest Dis Sci 36, 59–64 (1991). https://doi.org/10.1007/BF01300088
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DOI: https://doi.org/10.1007/BF01300088