Fibromyalgia and IBS (Irritable Bowel Syndrome): What’s the link?

It is also more likely that women develop fibromyalgia than men. According to research it has been estimated that fibromyalgia affects approximately 4% of women and 0.01% of men. [Source: Pubmed]

It is also common for those with fibromyalgia to experience digestive issues such as IBS. Studies have indicated that 73% of those with fibromyalgia have altered bowel patterns, a key symptom of IBS [Source: Pubmed].

When looking at this from an IBS perspective, it was found that up to 77% of those with IBS have symptoms that are aligned with fibromyalgia. [Source: Pubmed]

The fact that many people experience both sets of symptoms means that there may be similar root causes.

The fibromyalgia and IBS connection

Fibromyalgia and IBS have both been categorised as central sensitivity syndromes. This refers to one underlying aspect of these conditions being attributable to alterations in the central nervous system.

While they are not symptoms required for a diagnosis of IBS or commonly seen in this syndrome, a range of digestive issues and symptoms are commonly reported in those with fibromyalgia.

These additional digestive symptoms commonly seen in fibromyalgia include:

Nausea
Vomiting
Belching [Source: Pubmed]

It’s also been found that those with fibromyalgia also experience further symptoms of the upper GI tract.

This has been indicated in further studies that found up to 50% of those with fibromyalgia also experienced functional dyspepsia, commonly referred to as indigestion. [Source: Pubmed]

What are the symptoms of IBS?

IBS is described as a functional digestive disorder. This means that while no disease can be found (such as cancer) the function of the gut is impacted.

This then leads to a range of symptoms that include:

bloating
abdominal pain
altered bowel pattern (diarrhoea or constipation)

Even with the same symptoms, the underlying issues can vary which means the approach may often need to be highly individualised.

With the presence of these symptoms, it’s then possible to IBS to be divided into subtypes of IBS. This relates to the predominant types of bowel movements being experienced.

The 4 types of IBS include:

IBS-D (IBS with diarrhoea)
IBS-C (IBS with constipation)
IBS-M (IBS with mixed symptoms of constipation and diarrhoea)
IBS-U (IBS but their bowel habits cannot be accurately categorized as IBS-D, IBS-C, or IBS-M)

These can be defined as follows:

The IBS-D Subtype

More than 25% of bowel movements using the Bristol Stool Chart are type 6 or 7
Less than 25% of bowel movements are type 1 or 2.

The IBS-C Subtype

More than 25% of bowel movements are type 1 or 2 using the Bristol Stool Chart.
Less than 25% are type 6 or 7.

The IBS-M Subtype

More than 25% of bowel movements using the Bristol Stool Chart are types 1 and 2.
More than 25% are types 6 and 7.

The IBS-U Subtype

Patients who have the IBS-U subtype meet the diagnostic requirement for IBS, but their bowel habits cannot be accurately categorized as IBS-D, IBS-C, or IBS-M. [Source: AMJC]

Does SIBO (small intestinal bacterial overgrowth) cause fibromyalgia?

When assessing the balance of the bacteria in the small intestine, a 2008 study found that 100% of those with fibromyalgia tested positive for SIBO. In addition to this, the greater degree of abnormality in the results, the greater the severity of the pain in fibromyalgia. [Source: BMJ]

So, what is SIBO?

SIBO (small intestinal bacterial overgrowth) is a condition that has many of the same symptoms as IBS. Several studies have found that an overgrowth of bacteria in the small intestine (SIBO) is present in those with IBS. The number of those with SIBO as the cause of their IBS symptoms may be as high as 78%. [Source: Pubmed]

SIBO is indicated by an increase in bacteria in the small intestine and the symptoms include:

Abdominal pain or discomfort

Bloating
Flatulence
Changes in bowel patterns [Source: Pubmed]

Fibromyalgia and leaky gut

Studies have found that those with fibromyalgia have increased rates of leaky gut, often referred to as intestinal permeability.

As has been mentioned, those with fibromyalgia have higher rates of SIBO, which has been shown to impact the integrity of the gut lining. There is also evidence that improving the integrity and strength of the gut lining can improve disease activity.

A range of other factors can contribute to altered intestinal permeability/leaky gut.

These include:

Gut infections
Gut inflammation
Medications
Stress
Trauma

Many of those with fibromyalgia report that their symptoms started following an intestinal infection. This may be the trigger that also contributes to the increased rates of leaky gut in these fibromyalgia patients.

It is also known that increase stress (distress) can lead to or contribute to changes in the gut lining and increase intestinal permeability. [Source: Pubmed]

How to treat the pain of fibromyalgia?

There are several approaches to treating the pain of fibromyalgia. These can include the following:

Pain killers
Physical therapy
Natural supplements

PEA (palmitoylethanolamide) is a compound that has anti-inflammatory and pain-relieving properties. While this is produced naturally within the body, taking additional amounts of this through supplements has been found to reduce levels of pain. [Source: Pubmed]

Due to their anti-inflammatory benefits, omega-3 fish oils have been indicated to improve the symptoms seed in fibromyalgia as well as a range of inflammatory bowel conditions. [Source: Pubmed, Pubmed]

Curcumin and turmeric for fibromyalgia

Curcumin is an active compound in turmeric and it has shown a number of benefits in reducing pain.

Studies have found that nerve sensitivity is reduced with the use of curcumin as well as reduced levels of inflammation. [Source: Pubmed]

Ginger for fibromyalgia

Ginger contains a range of biologically active compounds that have pain-relieving modes of action. This is understood to be via ginger’s anti-inflammatory and antioxidant benefits.

Studies have found various pathways through which these compounds found in ginger lead to these improvements.

In experimental situations, ginger has also been found in to work well alongside paracetamol, increasing its benefits for pain reduction in fibromyalgia.

IBS & Fibromyalgia

There is a clear and significant link between these 2 conditions. This can involve bacteria changes such as SIBO as well as structural changes such as leaky gut.

Even though both of these can be seen in digestive issues, these imbalances have the potential to impact overall health and well-being. Contributing to the symptoms commonly seen in both IBS and fibromyalgia.

Rather than using painkillers to reduce symptoms or pain, working to address the underlying issue within the gut is the way we can help you to resolve your symptoms.

Fibromyalgia and IBS (Irritable Bowel Syndrome): What’s the link?

What is Fibromyalgia?

The fibromyalgia and IBS connection