Here we go again. So many symptoms associated with Fibromyalgia Syndrome (FMS) are similar to symptoms of other illnesses that making a clear diagnosis is often very difficult. Such is the case with Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD), which includes Crohn’s Disease and Ulcerative Colitis. All conditions have many symptoms in common, although they are distinctly different issues.
IBS is Not IBD
IBS is a syndrome, meaning that it is a collection of symptoms that indicate a particular disorder or condition. IBD (either Crohn’s or Colitis) are diseases that include bleeding and that can put patients at risk for colon cancer. The treatments vary greatly for IBS and IBD and if the wrong protocols are used for one or the other the end result can be ineffective or worse, dangerous.
Shared Symptoms of IBS and IBD
Some of the symptoms of IBS and IBD that are the same include the following:
· Abdominal pain
· Bloating or distension
· mucus in the bowel
· persistent diarrhea
· worsening of symptoms during menses
· urinary conditions
There are many symptoms associated with inflammatory bowel disease that are not at all associated with IBS; however, in spite of this, there is often a misdiagnosis of IBD as IBS or vice versa.
Connection between IBD and Fibromyalgia
According to a study done at the Department of Internal Medicine B, Soroka Medical Center, Ben-Gurion University of the Negev in Be’er Sheva, Israel, there was a clear connection made between IBD and fibromyalgia. The aim of the study was to determine the prevalence of FMS and assess the pain thresholds for FMS in people with Crohn’s Disease (CD) and ulcerative colitis (UC).
One hundred and thirteen patients with IBD, 72 with UC and 41 with CD were assessed for the presence of FMS tender points, based on the diagnosis criteria of the American College of Rheumatology 1990 criteria. The healthy control group numbered 120. Their findings were:
· FMS was found in 30 of the 113 patients with IBD, or 30%
· FMS was found specifically in 49% of patients with CD
· FMS was found specifically in 19% of patients with UC
· There was not FMS found in any of the control group
· Those with CD experienced more tenderness and had more frequent and severe FMS symptoms than those with UC
· Patients with CD had higher tender point count (11.3) than those with UC (6.4) while the control group count was 0.1
· Tenderness thresholds were lower in those with CD (2.9) than UC (3.9) with controls at 5.8
The conclusion of this study was that IBD is common in people with FMS, especially Crohn’s Disease. The fact that the people with Crohn’s had a lower pain threshold linked Crohn’s to FMS. By recognizing fibromyalgia in people with IBD, misdiagnosis can be avoided and correct treatment administered.
A Possible Reason Why IBD is Connected to FMS
There are a number of theories as to why fibromyalgia is common among those with Crohn’s and ulcerative colitis. One such theory is that because the onset and progression of symptoms for both conditions often occur at the same time, it may be that they have a common cause, that being excess pro-inflammatory cytokine activation. In a study done in 2009 at the Department of Gastroenterology, University Hospital of Heraklion, University of Crete Medical School in Crete, Greece, this theory was backed up. It found that:
· In 25% of people with IBD, musculoskeletal symptoms develop – the most common of which are arthritis and fibromyalgia.
· The symptoms happen either before or at the same time as IBD, not afterward, indicating that whatever caused the IBD could be accountable for the other conditions.
· Symptoms of IBD and the other conditions manifest and move parallel to one another.
· Successful treatment of the IBD often results in remission of musculoskeletal symptoms.
The bottom line of this study – and what appears to be consistent in dealing with IBD and fibromyalgia – is that controlling intestinal inflammation is a cornerstone therapeutic approach for the treatment of fibromyalgia.
Our article on Crohn’s Disease goes into great depth about this specific IBD. Read about it in this section.