Patients with IBS are at increased risk of fibromyalgia and chronic fatigue syndrome. This is according to recent research that builds on previous findings of a similar link between IBS and anxiety, depression, and suicide.

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.[1] 

“Because IBS patients have a 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.[2] “Earlier identification of comorbidities is valuable to inform treatment strategies, including consulting other specialities 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 hospitalised with IBS. The study included data from more than 1.2 million patients at 4,000 US hospitals.

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.”[2]

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

— Yezaz Ghouri, MD, University of Missouri School of Medicine

The psychiatric link

1. 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.[3][4]
2. 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.
3. 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.
4. Patients with IBS had greater odds of anxiety, depression, and suicide attempts/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.[4]

As he explained, “The mesentery membrane that holds the intestines together has one of the largest collections of nerve cells in the body. When those nerves start firing impulses, that can lead to a state of nervousness in and around the GI tract, resulting in IBS symptoms. The resulting decline in patient quality of life can lead to poor lifestyle choices, such as smoking.”

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.”[5]

Dr Chang utilises cognitive behavioural 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.” 

Disclaimer: This story is contributed by Katie Robinson and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.