Fibromyalgia And IBS

FIBROMYALGIA AND IBS can sometimes occur together. Studies have shown up to 60% have the two sets of symptoms!

This is significant, and not too surprising, given the overlap features that can occur with both conditions including tiredness, muscle aches, hypersensitivity, headaches and migraines.

Fibromyalgia and IBS

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  • Symptoms - an outline of the symptoms of fibromyalgia and also the irritable bowel syndrome
  • Cause - what are the causes?
  • Investigation - are there any investigations you need when suffering from the two conditions
  • Treatment - what therapies can be used to help improve symptoms?

Symptoms Of Fibromyalgia and IBS

You already know the main IBS symptoms of abdominal pain, diarrhea and constipation, but those of fibromyalgia may be a little less clear to you.

I've already mentioned some of the overlap features, but common ones include:

  • Painful Muscles, Tendons, Ligaments and Skin
  • Sleep Disturbance
  • Fatigue
  •  TMJ or Temporo-Mandibular Joint Pain (Jaw Pain)
  •  Chest Pain
  •  Irritable Bladder
  • Dizziness
  • Sensitivity to light, smells, touch and medicines

The name fibromyalgia is descriptive itself, fibro coming from the Latin for FIBROUS and myalgia meaning PAINFUL muscles.

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Cause

With the link between this condition and Irritable Bowel Syndrome, you would think that there may be a common cause.

Small intestinal bacterial overgrowth has been linked to both conditions, but treating them only provides transient improvement in symptoms (1).

To date, we just don’t know the underlying cause for them. I've previously discussed potential causes of Irritable Bowel Syndrome and some of these theories overlap with fibromyalgia too.

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Investigation

There is no one INVESTIGATION. It is a diagnosis made by the set of symptoms you have and exclusion of other conditions that can mimic the condition.

If fibromyalgia and IBS coincide, bowel investigations may be needed such as colonoscopy to exclude other conditions.

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Diagnosing

To diagnose Irritable Bowel Syndrome you have to have had symptoms for at least 3 months.

The DIAGNOSIS of fibromyalgia needs to include:

  • Bilateral Widespread Pain For At Least 3 Months
  • Multiple Tender or Trigger Points

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Treatment Options

The treatment of both conditions is very similar. These may include:

DRUGS – The use of SSRI and tricyclic antidepressant therapies have been very useful in the management of these conditions, both for pain control and depression symptoms. If sleep is an issue, the use of Amitriptyline and Mirtazapine are particularly useful.

SIMPLE ANALGESICS or painkillers can help some including acetaminophen, Paracetamol, codeine and more complex treatments such as Tramadol.

ANTICONVULSANTS – drugs such as Pregabalin and Gabapentin can modify pain and are sometimes useful.

ANTIPSYCHOTICS – drugs such as chlorpromazine, haloperidol, olanzapine and Risperidone can all play a part in the management, although they do have side effects such as Parkinson-like symptoms and tremor in some.

COGNITIVE BEHAVIOURAL THERAPY and PsychotherapyCognitive behavioural therapy can be helpful in both Fibromyalgia and IBS. This involves altering perception of illness and trying to create positive thoughts through talking about your symptoms.

MASSAGE – Massage therapy such as aromatherapy may help with muscle pain.

HYPNOTHERAPY – as with IBS, hypnosis can help with altering perception of symptoms

ACUPUNCTURE – Through the use of needle placement, acupuncture is a useful adjunct in the management.

LIFESTYLE CHANGES – Diet, exercise and swimming may help some people with their symptoms.

HERBAL REMEDIES - There are many herbal remedies, and like Irritable Bowel Syndrome, they have a role in the management of Fibromyalgia too.

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References:

1) Fibromyalgia: The Intestinal Link

Wallace, DJ et al. Curr Pain Headache Rep. 2004 Oct;8(5):364-8. Review

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