Fibromyalgia Severity and Symptoms Are Associated with the Disorders of Gut-brain Interaction

Overview

Journal Eur J Pain

Publisher Wiley

Specialties Critical Care
Neurology
Psychiatry

Date 2024 Dec 12

PMID 39665371

Authors

Sharon Erdrich

Joanna E Harnett

Affiliations

Soon will be listed here.

Abstract

Introduction: Fibromyalgia remains an idiopathic common disorder characterised by widespread pain with no universally accepted treatment. Irritable bowel syndrome is prevalent among women living with fibromyalgia. The prevalence of other disorders of gut-brain interaction (DGBI) and associations with fibromyalgia symptoms and severity is unknown.

Objectives: To evaluate the prevalence of the range of DGBI and associations with the symptoms and severity of fibromyalgia in women.

Methods: A prospective observational study was conducted in New Zealand in 2022. A comprehensive survey included validated measures to identify DGBI (Rome IV) and items assessing the severity of fibromyalgia and pain symptoms, sleep quality, quality of life, mental health and migraine. Analysis was conducted employing Spearman's rho, Mann-Whitney U, Kruskal-Wallis and chi-square tests.

Results: A total of 111 adult women with fibromyalgia enrolled in the study. Of these, 98 (93%) met the criteria for at least one DGBI, and 67 (68%) satisfied criteria for more than one. All groups of DGBI, and 11 specific DGBI were significantly associated with measures of pain, fibromyalgia severity, sleep problems and migraine (p < 0.05). Severity of pain and symptoms associated with fibromyalgia, including sleep problems, were also significantly associated with the functional bowel disorder severity index.

Conclusion: This study demonstrated that the prevalence of DGBI in women with fibromyalgia extends beyond irritable bowel syndrome. Presence of multiple DGBI correlates with pain, severity indices of fibromyalgia and sleep problems. Further research is required to examine the aetiology of DGBI in this population.

Significance Statement: This observational study has identified important relationships between the broader DGBI, fibromyalgia pain and associated symptoms, particularly migraine and sleep disturbance. Notable correlations between the severity indices of each are demonstrated, suggesting that improvements in one domain may reduce pain and improve overall well-being. These findings highlight the importance of addressing each clinical feature of the condition when supporting patients with fibromyalgia.

Citing Articles

Management of Fibromyalgia: Novel Nutraceutical Therapies Beyond Traditional Pharmaceuticals.

Antonelli A, Bianchi M, Fear E, Giorgi L, Rossi L Nutrients. 2025; 17(3).

PMID: 39940388 PMC: 11820827. DOI: 10.3390/nu17030530.

References

Faul F, Erdfelder E, Buchner A, Lang A . Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009; 41(4):1149-60. DOI: 10.3758/BRM.41.4.1149. View

Di Stefano M, Pucci E, Miceli E, Pagani E, Brondino N, Nappi G . Prevalence and pathophysiology of post-prandial migraine in patients with functional dyspepsia. Cephalalgia. 2019; 39(12):1560-1568. DOI: 10.1177/0333102419857596. View

Turner-Mcgrievy G, Hutto B, Bernhart J, Wilson M . Comparison of the Diet ID Platform to the Automated Self-administered 24-hour (ASA24) Dietary Assessment Tool for Assessment of Dietary Intake. J Am Nutr Assoc. 2021; 41(4):360-382. PMC: 8634522. DOI: 10.1080/07315724.2021.1887775. View

Almansa C, Rey E, Garcia Sanchez R, Alvarez Sanchez A, Diaz-Rubio M . Prevalence of functional gastrointestinal disorders in patients with fibromyalgia and the role of psychologic distress. Clin Gastroenterol Hepatol. 2009; 7(4):438-45. DOI: 10.1016/j.cgh.2008.12.005. View

Wolfe F, Walitt B, Rasker J, Katz R, Hauser W . The Use of Polysymptomatic Distress Categories in the Evaluation of Fibromyalgia (FM) and FM Severity. J Rheumatol. 2015; 42(8):1494-501. PMC: 4755344. DOI: 10.3899/jrheum.141519. View

Choy E . The role of sleep in pain and fibromyalgia. Nat Rev Rheumatol. 2015; 11(9):513-20. DOI: 10.1038/nrrheum.2015.56. View

Minerbi A, Gonzalez E, Brereton N, Fitzcharles M, Chevalier S, Shir Y . Altered serum bile acid profile in fibromyalgia is associated with specific gut microbiome changes and symptom severity. Pain. 2022; 164(2):e66-e76. DOI: 10.1097/j.pain.0000000000002694. View

Penn I, Chuang E, Chuang T, Lin C, Kao C . Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations. BMJ Open. 2019; 9(4):e026581. PMC: 6500182. DOI: 10.1136/bmjopen-2018-026581. View

Sperber A, Bangdiwala S, Drossman D, Ghoshal U, Simren M, Tack J . Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology. 2020; 160(1):99-114.e3. DOI: 10.1053/j.gastro.2020.04.014. View

10.

Plummer F, Manea L, Trepel D, McMillan D . Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry. 2016; 39:24-31. DOI: 10.1016/j.genhosppsych.2015.11.005. View

11.

Queiroz L . Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep. 2013; 17(8):356. DOI: 10.1007/s11916-013-0356-5. View

12.

Heidari F, Afshari M, Moosazadeh M . Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatol Int. 2017; 37(9):1527-1539. DOI: 10.1007/s00296-017-3725-2. View

13.

Farmer A, Aziz Q . Mechanisms of visceral pain in health and functional gastrointestinal disorders. Scand J Pain. 2018; 5(2):51-60. DOI: 10.1016/j.sjpain.2014.01.002. View

14.

van der Meer H, Visscher C, Vredeveld T, Nijhuis van der Sanden M, Engelbert R, Speksnijder C . The diagnostic accuracy of headache measurement instruments: A systematic review and meta-analysis focusing on headaches associated with musculoskeletal symptoms. Cephalalgia. 2019; 39(10):1313-1332. PMC: 6710620. DOI: 10.1177/0333102419840777. View

15.

McHorney C, Ware Jr J, Lu J, Sherbourne C . The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994; 32(1):40-66. DOI: 10.1097/00005650-199401000-00004. View

16.

de Tommaso M, Federici A, Serpino C, Vecchio E, Franco G, Sardaro M . Clinical features of headache patients with fibromyalgia comorbidity. J Headache Pain. 2011; 12(6):629-38. PMC: 3208047. DOI: 10.1007/s10194-011-0377-6. View

17.

Drossman D, Li Z, Toner B, Diamant N, Creed F, Thompson D . Functional bowel disorders. A multicenter comparison of health status and development of illness severity index. Dig Dis Sci. 1995; 40(5):986-95. DOI: 10.1007/BF02064187. View

18.

Bennett R, Friend R, Jones K, Ward R, Han B, Ross R . The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther. 2009; 11(4):R120. PMC: 2745803. DOI: 10.1186/ar2783. View

19.

Walitt B, Katz R, Bergman M, Wolfe F . Three-Quarters of Persons in the US Population Reporting a Clinical Diagnosis of Fibromyalgia Do Not Satisfy Fibromyalgia Criteria: The 2012 National Health Interview Survey. PLoS One. 2016; 11(6):e0157235. PMC: 4900652. DOI: 10.1371/journal.pone.0157235. View

20.

Tang N, Goodchild C, Sanborn A, Howard J, Salkovskis P . Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep. 2012; 35(5):675-87A. PMC: 3321427. DOI: 10.5665/sleep.1830. View