From the FMAS Global News Desk of Jeanne Hambleton
Nearly all fibromyalgia patients had functional gastrointestinal disorder, compared to 39 percent of study controls
Source: Health Day: Apr 16, 2009
THURSDAY, April 16 (HealthDay News) — A large majority of individuals with fibromyalgia also had functional gastrointestinal disorders (FGID), which may be related to psychological distress, according to research published in the April issue of Clinical Gastroenterology and Hepatology.
Cristina Almansa, M.D., of the Hospital Clinico San Carlos in Madrid, Spain, and colleagues analyzed data from 100 patients with fibromyalgia and 100 controls. All completed the Rome II Integrative Questionnaire, to determine gastrointestinal symptoms and FGID, and the Symptom Checklist-90 Revised for psychological distress. Controls also completed the Chronic Widespread Pain Questionnaire to detect potential fibromyalgia cases.
Most fibromyalgia patients (98 percent) had at least one FGID, compared to 39 percent of controls, the investigators found. The strongest association with fibromyalgia was with irritable bowel syndrome, functional bloating and functional fecal incontinence. Those with fibromyalgia had higher levels of somatization, obsessivity, anxiety and depression, the researchers report.
“An interesting hypothesis that could support the striking prevalence of FGID in patients with fibromyalgia would be an increased visceral sensitivity added to the somatic hypersensitivity characteristic of fibromyalgia in certain patients, which may make them more vulnerable to report gastrointestinal symptoms. Previous studies have shown enhanced visceral sensitivity in patients with irritable bowel syndrome when compared with fibromyalgia and healthy subjects, in contrast to patients with fibromyalgia who present with increased somatic sensitivity,” the authors write.
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ABSTRACT: Volume 7, Issue 4, Pages 438-445 (April 2009)
Authors: Cristina Almansa, Enrique Rey, Raquel García Sánchez, Ángel Álvarez Sánchez, Manuel Díaz–Rubio
Published online 15 December 2008.
Background & Aims
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.
From a Spanish population, 100 patients with fibromyalgia and 100 matched controls completed the Rome II Integrative Questionnaire to assess the prevalence of FGID and the Symptom Checklist-90 Revised (SCL-90R) to evaluate psychologic distress. Patients completed the Fibromyalgia Impact Questionnaire to evaluate the overall impact of fibromyalgia and controls filled out the Chronic Widespread Pain Questionnaire to detect potential cases of fibromyalgia.
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.
There is a prevalence of FGID in patients with fibromyalgia and a wider distribution of such symptoms along the gastrointestinal tract compared with controls. We propose that an increased degree of psychologic distress in these patients predisposes them to FGID, especially significant for anorectal syndromes.
Abbreviations used in this paper: FGID, functional gastrointestinal disorder, FIQ, Fibromyalgia Impact Questionnaire, FM, fibromyalgia, GSI, global severity index, IBS, irritable bowel syndrome, PSDI, positive symptom distress index, PST, positive symptom total, SCL-90R, Symptom Checklist-90 Revised
Digestive Diseases Department, Hospital Clínico San Carlos, Madrid, Spain
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