Patients with IBS are at increased risk of somatic disorders, such as fibromyalgia and chronic fatigue syndrome, according to a study by investigators at the University of Missouri School of Medicine. Findings from the 3-year study were published in Biomedicines.

Tarar ZI, Farooq U, Nawaz A, et al. Prevalence of fibromyalgia and chronic fatigue syndrome among individuals with irritable bowel syndrome: an analysis of United States National Inpatient Sample database. Biomedicines. 2023;11(10):2594.

 

 

“Because IBS patients have higher prevalence of somatic comorbidities such as fibromyalgia and chronic fatigue syndrome, identifying and treating these disorders can improve their quality of life,” said lead researcher Zahid Ijaz Tarar, MD, in a news release from the university.

University of Missouri School of Medicine. Irritable bowel syndrome patients suffer higher rates of fibromyalgia and chronic fatigue syndrome. January 9, 2024.

“Earlier identification of comorbidities is valuable to inform treatment strategies, including consulting other specialties such as rheumatology and psychiatry to improve the overall health outcomes in IBS patients.”

 

 

Dive into the research

 

Using data from the National Inpatient Sample (NIS) database from 2016–2019, the researchers studied the prevalence of fibromyalgia and chronic fatigue syndrome, along with their predictors, in individuals hospitalized with IBS. The study included data from more than 1.2 million patients at 4,000 US hospitals.

Of the patients with IBS, 10.73% also had fibromyalgia (mean age 58.7 years, 96.5% women) and 0.42% had chronic fatigue syndrome (mean age 59.9 years, 89.9% women). The prevalence of fibromyalgia and chronic fatigue syndrome were both five times higher in patients with IBS compared with the general adult population without IBS.

University of Missouri School of Medicine. Irritable bowel syndrome patients suffer higher rates of fibromyalgia and chronic fatigue syndrome. January 9, 2024.

 

In the news release, senior author and gastroenterologist Yezaz Ghouri, MD, said, “It is important that clinicians look for and manage somatic comorbidities in IBS patients.”

University of Missouri School of Medicine. Irritable bowel syndrome patients suffer higher rates of fibromyalgia and chronic fatigue syndrome. January 9, 2024.

 

This is yet another example where ailments in the gut are linked to ailments elsewhere in the body and mind.

 

The psychiatric link

 

The study builds on previous work by the investigators that looked at the prevalence of psychiatric problems in patients with IBS using NIS data from the same patient population.

Tarar ZI, Farooq U, Zafar Y, et al. Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: a nationwide analysis. Ir J Med Sci. 2023;192(5):2159–2166.

University of Missouri School of Medicine. Irritable bowel syndrome patients suffer high rates of anxiety and depression. February 22, 2023.

 

The results showed that 38.1% had anxiety and 27.4% had depression, both double the rate in adult patients with IBS compared with the general population without IBS. The prevalence of bipolar disorder (5.22% vs 2.38%), suicidal attempt/ideation (3.22% vs 2.38%), and eating disorders (0.32% vs 0.08%) were also higher in patients with IBS compared with the general adult population. Patients with IBS had greater odds of anxiety, depression, and suicide attempt/ideation. 

 

A variety of symptoms

 

“I frequently tell my patients who have IBS, that if they have any type of psychological stress, it will get expressed in some form or the other,” said Dr. Ghouri.

University of Missouri School of Medicine. Irritable bowel syndrome patients suffer high rates of anxiety and depression. February 22, 2023.

 

 

Lin Chang, MD, a gastroenterologist and physician scientist at the University of California in Los Angeles, who was not involved in the studies, has suggested that environmental factors including stress may contribute to the development of IBS and chronic fatigue or trigger a flare. “It’s possible that the combination of chronic stress and a certain genetic type would predispose an individual to getting IBS and chronic fatigue syndrome.”

Wheeler RB. Irritable bowel syndrome and chronic fatigue syndrome: What’s the connection? EverydayHealth. September 20, 2023.

 

Dr. Chang utilizes cognitive behavioral therapy, medications to reduce pain, and lifestyle changes—all of which may improve mood and sleep—as interventions that may ease symptoms. “You have to treat multiple symptoms, and patients have a harder time managing their symptoms because it’s overwhelming sometimes.”