Fibromyalgia in the irritable bowel syndrome: Studies of prevalence and clinical implications

OBJECTIVE: The irritable bowel syndrome (IBS) and the fibromyalgia syndrome (FS) coexist in many patients. We conducted complementary studies of the p revalence of FS in IBS patients and matched controls, and of IBS in FS pati ents and the implications of concomitant IBS and FS on health-related quali ty of life (HRQOL). METHODS: A study of 79 IBS patients with 72 matched controls (IBS study), a nd a study of 100 FS patients (FS study). All participants underwent tests of tender point sites and threshold of tenderness and answered questionnair es including personal and medical history, GI symptoms, and indices of HRQO L. RESULTS: In the IBS study, 25 of the 79 IBS patients (31.6%) and 3 of the 7 2 controls (4.2%) had FS (p < 0.001). Statistically significant differences were found among the study groups in terms of global well-being (p < 0.001 ), sleep disturbance (p < 0.001), physician visits (p = 0.003), pain (p < 0 .001), anxiety (p < 0.001), and global severity index (SCL-90-R) (p < 0.001 ), with patients with IBS and FS having the worst results. IBS patients had significantly more tender points than controls (p < 0.001). In the FS stud y, 32 of the 100 FS patients (32%) had IBS. Patients with both disorders ha d significantly worse scores for physical functioning (p = 0.030) and for a ll but one of a 16-item quality of life questionnaire. CONCLUSIONS: FS and IBS coexist in many patients. Patients with both disord ers have worse scores on HRQOL indices than patients with either disorder a lone, or controls. Physicians treating these patients should be aware of th e overlap, which can affect the presentation of symptoms, health care utili zation, and treatment strategies. (Am J Gastroenterol 1999;94:3541-3546. (C ) 1999 by Am. Coll. of Gastroenterology).