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The association of functional gastrointestinal disorders & fibromyalgia (FM)

  [ 57 votes ]   [ Discuss This Article ]
By Chang L • • January 2, 1998

Previous epidemiological studies have confirmed the clinical
impression that functional gastrointestinal disorders
typically overlap with fibromyalgia (FM) in the same patient,
suggesting a common etiology. FM syndrome occurs in up to 60%
of patients with functional bowel disorders. Up to 50% of
patients with a diagnosis of FM syndrome complain of symptoms
characteristic of functional dyspepsia and 70% have symptoms
of IBS. These two conditions have common clinical
characteristics: (1) the majority of patients associate
stressful life events with the initiation or exacerbation of
symptoms, (2) the majority of patients complain of disturbed
sleep and fatigue, (3) psychotherapy and behavioral therapies
are efficacious in treating symptoms, and (4) low-dose
tricyclic antidepressant medication can improve symptoms.

Despite these similarities, their perceptual responses to both
somatic and visceral stimuli differ. While FM patients
characteristically exhibit somatic hyperalgesia, IBS patients
without coexistent FM have somatic hypoalgesia to mechanical
stimuli. Visceral distention studies have also demonstrated
perceptual alterations in patients with IBS and FM although
these findings appear to differ in the two conditions. Further
studies will help explore the mechanisms which are responsible
for the similarities and differences in clinical symptoms and
physiologic parameters seen in IBS and FM.

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