Link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing
This is an interesting one. Although the diagnosis of fibromyalgia no longer seems to be the “flavor of the month,” patients with symptoms that would match those in FM are still walking around. Here is my concern: I firmly believe that a relatively small amount of true FM patients really exist. I feel that FM is more of a systemic manifestation of IBS. Dysfunction of the GI tract can explain all the symptoms of FM if you follow the physiology. In this study, the authors found evidence of small bowel bacterial overgrowth in both IBS and FM patients, and the patients with more overgrowth the more likely they had somatic (muscle) pain.
Research has shown that small bowel bacterial overgrowth can occur with anti-secretory therapy for GI complaints and from destruction of normal, protective bacterial flora. Some research has also shown the small bowel bacterial overgrowth will increase small bowel permeability–basically stuff is getting into the body that shouldn’t be and the body has no choice but to react and attach the invaders. Then, following that further, small bowel bacterial overgrowth has been linked to non-alcoholic steatohepatitis. So, not only could we have an upregulated immune system from the leaky gut, but the liver is now likewise burdened. Put these together and you’ve got a recipe for FM.
Ann Rheum Dis — Abstracts: Pimentel et al. 63 (4): 450 –