Fibromyalgia, Gastrointestinal Disorders and Psychologic Distress
Are the gastrointestinal problems that often accompany fibromyalgia caused by psychologic distress? A study published in the April 2009 issue of the journal Clinical Gastroenterology and Hepatology says yes. I say they are jumping to conclusions without sufficient evidence.
First of all, they started with an inaccurate premise, namely that "Fibromyalgia is a rheumatologic disorder associated with somatic and psychologic conditions." It has repeatedly been shown that depression and other psychological problems are no more prevalent with fibromyalgia than they are with any other chronic illness.
The results of the study, conducted in Spain, showed that 98 percent of the FM patients had some kind of GI problem. That doesn’t surprise me at all. It also showed that the FM patients had higher scores of psychologic distress than the healthy controls. That also doesn’t surprise me. I’d venture to say that almost everyone who lives with a chronic painful illness of any kind has some degree of psychologic distress - certainly more than someone who is perfectly healthy.
From this, the researchers concluded that the increased psychologic distress in FM patients predisposed them to GI disorders. Here’s where I have a big problem. There are several other possible causes for the GI problems that were not included in the study or even considered. Two that immediately come to mind are:
- Fibromyalgia is a central nervous system disorder that causes hypersensitivity. Not only are we hypersensitive to pain, we’re also often hypersensitive to medications, chemicals, light, sound, etc. It seems reasonable to think there’s a good chance our digestive systems may also be hypersensitive, which could result in a variety of GI disorders.
- Many of the medications we take have side effects that affect our digestive systems. I did a quick check of the most commonly prescribed medications for FM and every single one listed one or more of the following adverse reactions: nausea, vomitting, constipation, diarrhea - all GI disorders.
Until and unless these other factors are taken into consideration, I don’t think we can jump to any conclusions about the impact of psychologic distress on GI disorders and fibromyalgia.
Frankly, I’m sick and tired of continuing to see precious research dollars being wasted on poorly constructed studies designed to link fibromyalgia to psychological problems. It’s time researchers stopped beating that dead horse and started trying to find better treatments for us. I’d even venture to say that if they could find a way to relieve the pain and fatigue, whatever psychologic distress we might have would go away as well.
Source: Almansa, Cristina, et al (2009, April). Prevalence of Functional Gastrointestinal Disorders in Patients With Fibromyalgia and the Role of Psychologic Distress. Clinical Gastroenterology and Hepatology, Volume 7, Issue 4.
Karen is the co-founder of the National Fibromyalgia Association. She wrote for HealthCentral as a patient expert for Pain Management.