A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

2020 ◽  
Author(s):  
Sharon Erdrich

Abstract Background Fibromyalgia and functional gastrointestinal disorders are frequently encountered in clinical settings. Common to both is significant burden on individuals and health care systems, an elusive aetiology and several comorbid conditions. While a relationship between irritable bowel syndrome and fibromyalgia has been demonstrated, a broader review of the relationship between fibromyalgia and other functional gut disorders has not been undertaken. Objectives This paper reports a systematic review of the published literature, identifying the comorbidity of functional gastrointestinal disorders in people with fibromyalgia. We discuss the clinical implications, limitations of current research, and areas of interest for future research Methods A systematic review of the databases Medline, Embase, CINAHL and Web of Science was undertaken in June 2019. Results were screened for original articles meeting strict criteria for identification of functional gastrointestinal disorders in adult subjects with fibromyalgia. ResultsFourteen articles were included investigating 1340 subjects with fibromyalgia, 363 healthy controls and 441 subjects with other pathologies. Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating/gas, irritable bowel of mixed-pattern and constipation-types were more prevalent that diarrhoea-predominant irritable bowel in adults with fibromyalgia. One study reported the range of functional gastrointestinal disorders. Conclusion Existing research has focused on the relationship between irritable bowel syndrome and fibromyalgia, but sub-typing of irritable bowel syndrome is generally overlooked. A strong association with a range of functional gastrointestinal disorders is suggested. Further investigation is needed to determine the prevalence and relevance of the range of functional gastrointestinal disorders in patients with fibromyalgia.

2020 ◽  
Author(s):  
Monica Tosto ◽  
Paola D’Andrea ◽  
Ignazio Salamone ◽  
Salvatore Pellegrino ◽  
Stefano Costa ◽  
...  

Abstract Background Rome IV criteria for functional gastrointestinal disorders state that children suspected of having Irritable Bowel Syndrome (IBS) with Constipation (IBS-C) should be preliminarily treated for constipation. We aimed at verifying if functional constipation may indeed lead to an erroneous diagnosis of IBS with diarrhea (IBS-D) or IBS with mixed pattern of diarrhea and constipation (IBS-M).Methods We prospectively enrolled in an unblinded fashion 10 and 16 consecutive children referred to our center who met Rome IV criteria for a diagnosis of IBS-D and IBS-M, respectively. Patients who fulfilled criteria for suspect “occult constipation” were then given a bowel cleaning regimen with PEG 3350, re-evaluated at 2 months and followed up for at least 6 months. Sixteen additional patients with IBS with Constipation (IBS-C) referred in the same period served as control. The endpoints were: 1) a decrease of more than 50% in abdominal pain intensity and frequency scores; and 2) for patients with IBS-D and IBS-M: resolution of diarrhea.Results The endpoints were met by 8 (80%) and 14 (87%) of the patients with IBS-D and IBS-M, respectively, with decrease of abdominal pain and resolution of “diarrhea”. The response was not significantly different from that observed in 15 (93%) of the IBS-C control group.Conclusion acknowledging the limitations of the small number of patients and of the uncontrolled nature of the study, we suggest that a possibly large number of patients labeled as IBS-D or IBS-M may actually simply present functional constipation and should be managed as such.


2020 ◽  
Vol 13 ◽  
pp. 175628482097740
Author(s):  
Sharon Erdrich ◽  
Jason A. Hawrelak ◽  
Stephen P. Myers ◽  
Joanna E. Harnett

Background: Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research Methods: Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia. Results: A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia. Conclusion: This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.


Author(s):  
A.V. Zubarenko ◽  
V.V. Luzan ◽  
T.Yu. Kravchenko ◽  
G.K. Kopiyka ◽  
V.I. Martyuk

Functional gastrointestinal disorders are considered as a clinical variant of the interaction between psychosocial factors and gastrointestinal tract physiology implemented through the "brain - intestine" axis. The purpose of the study was to investigate psychological peculiarities of children with irritable bowel syndrome. The study included 68 children aged from 14 to 18 years with the confirmed diagnosis of irritable bowel syndrome. To determine the type of character accentuation, the Schmishek -Leonhard test questionnaire (child version) was used. The SCL-90-R test questionnaire (by L. Derogatis method) was applied to determine psycho-emotional disorders. The study has found out the majority of patients have certain psycho-emotional disorders. The group of children with irritable bowel syndrome, who were experiencing constipation, more frequently demonstrated an emotional type of character accentuation and a somatized and depressed type of psychological disorders. The patients with irritable bowel syndrome and diarrhoea had cycloid and demonstrative types of character accentuation and demonstrated an anxious type according to the questionnaire. The patients with mixed bowel rhythms exhibited features of a cycloid, emotional, and pedantic type of character accentuation. Depression, anxiety, somatised types were reported as manifestations of psychological disorders.


2020 ◽  
Vol 11 ◽  
Author(s):  
Chloé Melchior ◽  
Charlotte Desprez ◽  
Fabien Wuestenberghs ◽  
Anne-Marie Leroi ◽  
Antoine Lemaire ◽  
...  

Objective: We aimed to determine the burden of opioid consumption in a cohort of patients with functional gastrointestinal disorders.Methods: All patients diagnosed with functional gastrointestinal disorders and referred to our university hospital were evaluated from 2013 to the beginning of 2019. Irritable bowel syndrome and functional dyspepsia diagnoses were determined according to Rome criteria and severity according to irritable bowel syndrome severity scoring system. Vomiting was quantified using a 5-point Likert scale, and constipation severity was measured using the Knowles-Eccersley-Scott-Symptom questionnaires. Quality of life was quantified by the GastroIntestinal Quality of Life Index. Patients were categorized as being treated on a chronic basis with either tramadol, step II opioids, step III opioids or as being opioid-free.Results: 2933 consecutive patients were included. In our cohort, 12.5% had only irritable bowel syndrome, 39.3% had only functional dyspepsia, 24.9% had a combination of both, and 23.4% had other functional gastrointestinal disorders. Among them, the consumption of tramadol, step II (tramadol excluded) and step III opioids was 1.8, 1.3 and 0.3 % respectively in 2013 and 4.3, 3.4 and 1.9% in 2018 (p < 0.03). Opioid consumption was associated with increased vomiting (p = 0.0168), constipation (p < 0.0001), symptom severity (p < 0.001), more altered quality of life (p < 0.0001) and higher depression score (p = 0.0045).Conclusion: In functional gastrointestinal disorders, opioid consumption has increased in the last years and is associated with more GI symptoms (vomiting, constipation and GI severity), higher depression and more altered quality of life.


2015 ◽  
Vol 6 (2) ◽  
pp. 209-217 ◽  
Author(s):  
S. Guandalini ◽  
E. Cernat ◽  
D. Moscoso

Underlying pathophysiological mechanisms of irritable bowel syndrome (IBS), a common disorder characterized by abdominal pain associated to a change in stool consistency or frequency, include low-grade inflammation and intestinal microbiota changes. Few and disappointing data are available for prebiotics. A few controlled trials (RCTs) of probiotics are instead available with favourable effects, although most are limited by suboptimal design and small sample size. A recent report from the Rome foundation group included 32 RCTs of probiotics, most of which showed an overall modest improvement in symptoms, with the patients most benefitting from probiotics being those with predominant diarrhoea and those having a post-infectious IBS. A review focusing only on children with functional gastrointestinal disorders concluded that probiotics are more effective than placebo in the treatment of patients with abdominal pain-related functional gastrointestinal disorders, although no effect on constipation was evident. The role for probiotics in inflammatory bowel disease (IBD) appears logical: the endogenous intestinal microbiota plays a central role in their development, and various probiotics have been found effective in animal models of IBD. However, research in humans has been overall quite limited, and it would seem that after a phase of intense research in the first decade of this century, the pace has slowed down, with fewer clinical trials been published in the past 2-3 years. To summarize current evidence: no probiotic has proven successful in Crohn's disease. In ulcerative colitis, on the other hand, data are more promising, and a very recent meta-analysis, that included 23 randomized controlled trials, concluded that there is evidence of efficacy for the probiotic mixture VSL#3 in helping inducing and maintaining remission, as well as in maintaining remission in patients with pouchitis. It is fair to state that for both IBD and IBS, more well-designed, rigorous, randomized clinical trials must be performed.


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