Association among Disorders of Gut-Brain Interaction (DGBI) and Fibromyalgia: A Prospective Study

Abstract

The disorders of gut-brain interaction (DGBI) have been associated with Fibromyalgia (FM). However, there are no data about the relationship between FM and DGBI using Rome IV criteria. This study aimed to evaluate the prevalence of FM in patients with Irritable Bowel Syndrome (IBS) and/or Functional Dyspepsia (FD) and the prevalence of IBS and FD in FM patients using Rome IV criteria. DGBI patients and FM patients were recruited from two outpatient clinics devoted to DGBI and FM. All patients underwent a standardized gastrointestinal (GI) symptoms questionnaire. FM symptoms in DGBI patients were assessed through Fibromyalgia Rapid Screening Tool (FiRST) and Fibromyalgia Impact Questionnaire. Thereafter, the rheumatologists evaluated them. 49.0% of FM patients fulfilled the diagnostic criteria for IBS, 81.6% for FD with an overlap for both IBS/FD in 44.9%. IBS-C was the most prevalent IBS-subtype in DGBI patients, whereas IBS-M was the most prevalent in FM patients (p = 0.01). 45.3% of DGBI patients reported pathological FiRST scores. DGBI patients with FM showed the highest score at the standardized GI questionnaire followed by FM patients with DGBI and DGBI without FM. In conclusion DGBI are common in FM patients and vice versa. The presence of FD is extremely frequent in FM patients. A multidisciplinary approach should be routinely used for the management of these patients.

Keywords: fibromyalgia; functional dyspepsia; gastrointestinal diseases; irritable bowel syndrome.

Figure 1

Prevalence of subtypes of IBS among FM patients. FM: fibromyalgia; IBS: irritable bowel syndrome; IBS-U: undetermined IBS; IBS-M: mixed IBS; IBS-C: constipation predominant IBS; IBS-D: diarrhea predominant IBS.

Figure 2

Prevalence of subtypes of FD among FM patients. FM: fibromyalgia; FD: functional dyspepsia; PDS: postprandial distress syndrome; EPS: epigastric pain syndrome.