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Rheumatology International
Published in: Rheumatology International 3/2015

01-03-2015 | Review Article - Pathology Review

An insight into the gastrointestinal component of fibromyalgia: clinical manifestations and potential underlying mechanisms

Authors: Mahmoud Slim, Elena Pita Calandre, Fernando Rico-Villademoros

Published in: Rheumatology International | Issue 3/2015

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Abstract

Fibromyalgia syndrome is characterized by chronic generalized pain accompanied by a broad symptomatologic spectrum. Besides chronic fatigue, sleep disturbances, headaches and cognitive dysfunction that are extensively described in the literature, a considerable proportion of patients with fibromyalgia experience gastrointestinal symptoms that are commonly overlooked in the studies that are not specifically dedicated to evaluate these manifestations. Nevertheless, various attempts were undertaken to explore the gastrointestinal dimension of fibromyalgia. Several studies have demonstrated an elevated comorbidity of irritable bowel syndrome (IBS) among patients with fibromyalgia. Other studies have investigated the frequency of presentation of gastrointestinal symptoms in fibromyalgia in a nonspecific approach describing several gastrointestinal complaints frequently reported by these patients such as abdominal pain, dyspepsia and bowel changes, among others. Several underlying mechanisms that require further investigation could serve as potential explanatory hypotheses for the appearance of such manifestations. These include sensitivity to dietary constituents such as gluten, lactose or FODMAPs or alterations in the brain–gut axis as a result of small intestinal bacterial overgrowth or subclinical enteric infections such as giardiasis. The gastrointestinal component of fibromyalgia constitutes a relevant element of the multidisciplinary pathophysiologic mechanisms underlying fibromyalgia that need to be unveiled, as this would contribute to the adequate designation of relevant treatment alternatives corresponding to these manifestations.
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Metadata
Title
An insight into the gastrointestinal component of fibromyalgia: clinical manifestations and potential underlying mechanisms
Authors
Mahmoud Slim
Elena Pita Calandre
Fernando Rico-Villademoros
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Rheumatology International / Issue 3/2015
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-014-3109-9

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