gastrointestinal symptoms, #IBS and #FM

Often when it comes to gastrointestinal complaints and fibromyalgia we get diagnosed with comorbid IBS with little investigation into it but there can be other underlying causes.

Fibromyalgia syndrome is characterized by chronic generalized pain accompanied by a broad symptomatologic spectrum. Besides chronic fatigue, sleep disturbances, headaches and cognitive dysfunction that are extensively described in the literature, a considerable proportion of patients with fibromyalgia experience gastrointestinal symptoms that are commonly overlooked in the studies that are not specifically dedicated to evaluate these manifestations.

Nevertheless, various attempts were undertaken to explore the gastrointestinal dimension of fibromyalgia. Several studies have demonstrated an elevated comorbidity of irritable bowel syndrome (IBS) among patients with fibromyalgia. Other studies have investigated the frequency of presentation of gastrointestinal symptoms in fibromyalgia in a nonspecific approach describing several gastrointestinal complaints frequently reported by these patients such as abdominal pain, dyspepsia and bowel changes, among others.

Several underlying mechanisms that require further investigation could serve as potential explanatory hypotheses for the appearance of such manifestations. These include sensitivity to dietary constituents such as gluten, lactose or FODMAPs or alterations in the brain–gut axis as a result of small intestinal bacterial overgrowth or subclinical enteric infections such as giardiasis. Prohealth

In my case I was diagnosed with IBS initially with little investigation then years later, after having a ulcer with NSAIDs and a continued NSAID sensitivity afterward they looked into the IBS more because it presented as IBS-D and not as one might commonly see as fluctuating IBS or the more common IBS-C. In which case I got to experience the barium test again as well as a colonoscopy. But they also tested me for celiac and for lactose intolerance. That does not mean to say I could not still be gluten sensitive, as that does not show on that test, or that a FODMAP diet could not benefit me but that they did not look into those issues. 

You do have to wonder at the cause of this symptom though. I will say it was not an initial symptom of mine. It came a few years past my actual diagnosis date, which means well after onset of the FM itself. But when the onset did occur it was pretty consistent from there in. We definitely do have a comorbid IBS occurrence but whether there are further issues at play is hard to determine.
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