Validation of New Symptom-Based Fibromyalgia Criteria for Irritable Bowel Syndrome Co-morbidity Studies – Source: Journal of Neurogastroenterology and Motility, Jan 2011

[Note: To read the full text of this open access article free, click HERE.  See also the free editorial: “Why should gastroenterologists know about fibromyalgia? Common pathogenesis and clinical implications.”]

Background/Aims:
There is significant co-morbidity between irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS). [Roughly one third of IBS patients have FMS & half of FM patients have IBS.] However, FMS is diagnosed by physical examination, which limits the conduct of co-morbidity studies in a large population-based study. The purpose of this study was to determine the diagnostic validity of new symptom-based criteria in patients with FMS and/or IBS using the American College of Rheumatology (ACR) criteria as a gold standard.

Methods: The study participants consisted of women with FMS (n = 30), IBS (n = 27) and controls (n = 28).

New symptom-based diagnostic criteria for FMS [included] a regional pain scale and a visual analogue scale for fatigue. [For background, see “ACR explains proposed new fibromyalgia diagnostic criteria,”  May 2010.]

• All subjects underwent a physical examination for FMS (ACR criteria) and structured questionnaires of regional pain scale and visual analogue scale for fatigue.

• A fibromyalgia intensity score was calculated and thresholds of tenderness were determined by a dolorimeter.

Results:

• The number of participants diagnosed with FMS in the entire study population (n = 85) was 31 by the new criteria.

• Compared to the ACR, the sensitivity of the new criteria was 82.9%, specificity 96.0%, positive predictive value 93.5% and negative predictive value 88.9%.

• In addition, new criteria were useful for the diagnosis of FMS among the subjects with IBS.

• A fibromyalgia intensity score was significantly correlated with the threshold of tenderness (r = -0.62, P < 0.001).

Conclusions:
The new symptom-based diagnostic criteria for the diagnosis of FMS can be used in large-scale clinical and epidemiological co-morbidity studies, in which physical examination is unfeasible. Gastroenterologists investigating the effects of co-morbid FMS in IBS patients can use these new criteria with confidence.

Source: Journal of Neurogastroenterology and Motility, Jan 2011. PMID: 21369494, by Sperber AD, Akiva S, Leshno M, Halpern Z, Buskila D. Department of Gastroenterology, Soroka Medical Center, Beer-Sheva, Israel. [Email: amy@bgu.ac.il]

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