Fibromyalgia: The gastrointestinal link

Wallace, Daniel J.; Hallegua, David S.

doi:10.1007/s11916-996-0009-z

Cited by 52 publications

(37 citation statements)

References 27 publications

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“…This might account for the delayed enhancement of muscle hyperalgesia induced by sound stress observed here. This hypothesis is consistent with the remarkable co-morbidity exhibited by patients suffering widespread pain and chronic gastrointestinal symptoms (64). …”

Section: Discussionsupporting

confidence: 84%

Stress in the Adult Rat Exacerbates Muscle Pain Induced by Early-Life Stress

Álvarez

Green

Levine

2013

Biological Psychiatry

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Background Early-life stress and exposure to stressful stimuli play a major role in the development of chronic widespread pain in adults. However, how they interact in chronic pain syndromes remains unclear. Methods Dams and neonatal litters were submitted to a restriction of nesting material (neonatal limited bedding, NLB) for one week. As adults, these rats were exposed to a painless sound stress protocol. The involvement of sympathoadrenal catecholamines, interleukin 6 (IL-6) and tumor necrosis alpha (TNFα) in nociception, was evaluated through of behavioral and ELISA assays, surgical interventions and intrathecal antisense treatments. Results Adult NLB rats exhibited mild muscle hyperalgesia, which was markedly aggravated by sound stress (peaking 15 days after exposure). Adrenal medullectomy did not modify hyperalgesia in NLB rats but prevented its aggravation by sound stress. Sustained administration of epinephrine to NLB rats mimicked sound stress effect. Intrathecal treatment with antisense directed to IL-6-receptor subunit gp130, but not to TNFα type 1 receptor (TNFR1), inhibited hyperalgesia in NLB rats. However, antisense against either gp130 or TNFR1 inhibited sound stress-induced enhancement of hyperalgesia. Compared to control rats, NLB rats exhibit increased plasma levels of IL-6 but decreased levels of TNFα, whereas sound stress increases IL-6 plasma levels in control but not in NLB rats. Conclusions Early-life stress induces a persistent elevation of IL-6, hyperalgesia and susceptibility to chronic muscle pain, which is unveiled by exposure to stress in adults. This probably depends on an interaction between adrenal catecholamines and pro-inflammatory cytokines acting at muscle nociceptor level.

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Section: Discussionsupporting

confidence: 84%

Stress in the Adult Rat Exacerbates Muscle Pain Induced by Early-Life Stress

Álvarez

Green

Levine

2013

Biological Psychiatry

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“…[10–12] Among these illnesses, food sensitivities are an essential determinant of inflammation that might be associated to FMS pain. This pain and inflammation can be provoked by particular foods, such as preservatives, eggs, and gluten; however, the food causing FMS symptoms differs from person to person.…”

Section: Introductionmentioning

confidence: 99%

Association between fibromyalgia syndrome and peptic ulcer disease development

Wang

Lin

et al. 2017

PLoS ONE

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PurposeThe correlation of fibromyalgia syndrome (FMS) with peptic ulcer disease (PUD) is unclear. We therefore conducted a cohort study to investigate whether FMS is correlated with an increased risk of PUD.MethodsIn this study, we established an FMS cohort comprising 26068 patients aged more than 20 years who were diagnosed with FMS from 2000 to 2011. Furthermore, we established a control cohort by randomly choosing 104269 people without FMS who were matched to the FMS patients by gender, age, and index year. All patients were free of PUD at the baseline. Cox proportional hazard regressions were performed to compute the hazard ratio of PUD after adjustment for demographic characteristics and comorbidities.ResultsThe prevalence of comorbidities was significantly higher in the FMS patients than in the controls. The incidence of PUD was 29.8 and 19.4 per 1000 person-years in the FMS and control cohorts, respectively. In addition, the FMS cohort exhibited a 1.40-fold higher risk of PUD (95% confidence interval = 1.35–1.45) compared with the control cohort. After control for confounding factors, the medications (selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, and antidepressants) taken by the FMS patients did not increase the risk of PUD.ConclusionFMS patients exhibit a higher risk of PUD than that of patients without FMS.

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“…Specifically, FMS occurs in 20 to 32% of people with IBS [1]. IBS has been found in 32 to 70% of people with FMS [2,3], and LE has been found in 16% of people with IBS, and in 56% of people with both IBS and FMS [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Effect of one year of a gluten-free diet on the clinical evolution of irritable bowel syndrome plus fibromyalgia in patients with associated lymphocytic enteritis: a case-control study

et al. 2014

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IntroductionIrritable bowel syndrome (IBS), lymphocytic enteritis (LE) and fibromyalgia syndrome (FMS) are three common disorders. Since a gluten-free diet (GFD) has been shown to be helpful in LE, we aimed to assess its effect in a series of LE patients also diagnosed with IBS and FMS.MethodsThe study sample comprised 97 IBS plus FMS adult females, of whom 58 had LE (Marsh stage 1), and 39 had a normal duodenal biopsy (Marsh stage 0). All patients fulfilled the Rome III and American College of Rheumatology 1990 criteria. All participants followed a GFD, the effectiveness of which was assessed by changes in the results of several tests, including those of the Fibromyalgia Impact Questionnaire (FIQ), the Health Assessment Questionnaire (HAQ), tender points (TPs), the Short Form Health Survey (SF-36), and the Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and fatigue.ResultsAt baseline, all patients had a poor quality of life (QoL) and high VAS scores. After one year on a GFD, all outcome measures were somewhat better in the Marsh stage 1 group, with a mean decrease of 26 to 29% in the TPs, FIQ, HAQ and VAS scales, accompanied by an increase of 27% in the SF-36 physical and mental component scores. However, in the IBS plus FMS/Marsh stage 0 group, the GFD had almost no effect.ConclusionsThis pilot study shows that a GFD in the LE-related IBS/FMS subgroup of patients can produce a slight but significant improvement in all symptoms. Our findings suggest that further studies of this subject are warranted.

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Fibromyalgia: The gastrointestinal link

Cited by 52 publications

References 27 publications

Stress in the Adult Rat Exacerbates Muscle Pain Induced by Early-Life Stress

Stress in the Adult Rat Exacerbates Muscle Pain Induced by Early-Life Stress

Association between fibromyalgia syndrome and peptic ulcer disease development

Effect of one year of a gluten-free diet on the clinical evolution of irritable bowel syndrome plus fibromyalgia in patients with associated lymphocytic enteritis: a case-control study

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