Fibromyalgia (FM) in the irritable bowel syndrome: studies of prevalence & clinical implications

OBJECTIVE: The irritable bowel syndrome (IBS) and the
fibromyalgia syndrome (FS) coexist in many patients. We
conducted complementary studies of the prevalence of FS in IBS
patients and matched controls, and of IBS in FS patients and
the implications of concomitant IBS and FS on health-related
quality of life (HRQOL).

METHODS: A study of 79 IBS patients
with 72 matched controls (IBS study), and a study of 100 FS
patients (FS study). All participants underwent tests of
tender point sites and threshold of tenderness and answered
questionnaires including personal and medical history, GI
symptoms, and indices of HRQOL.

RESULTS: In the IBS study, 25
of the 79 IBS patients (31.6%) and 3 of the 72 controls (4.2%)
had FS (p < 0.001). Statistically significant differences were
found among the study groups in terms of global well-being (p
< 0.001), sleep disturbance (p < 0.001), physician visits (p =
0.003), pain (p < 0.001), anxiety (p < 0.001), and global
severity index (SCL-90-R) (p < 0.001), with patients with IBS
and FS having the worst results. IBS patients had
significantly more tender points than controls (p < 0.001). In
the FS study, 32 of the 100 FS patients (32%) had IBS.
Patients with both disorders had significantly worse scores
for physical functioning (p = 0.030) and for all but one of a
16-item quality of life questionnaire.

CONCLUSIONS: FS and IBS
coexist in many patients. Patients with both disorders have
worse scores on HRQOL indices than patients with either
disorder alone, or controls. Physicians treating these
patients should be aware of the overlap, which can affect the
presentation of symptoms, health care utilization, and
treatment strategies.

Sperber AD, Atzmon Y, Neumann L, Weisberg I, Shalit Y, Abu-Shakrah M, Fich A, Buskila D

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