Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a common cause of lower
abdominal pain. The frequency of comorbidity in fibromyalgia is 59% compared to
15 to 20% in the general population. About 70% of those affected by
this disorder are women.1 It can be placed into one of three
subgroups: Constipation-predominant IBS; diarrhea-predominant IBS; and
alternating bowel habits or “pain predominant” IBS. This syndrome is a multisymptom complex that is manifested
by alteration in bowel habit frequency, stool consistency, and associated
abdominal discomfort (pain, cramping, bloating, etc.) IBS treatments are usually based on trying
to alleviate the predominant symptoms. For instance, if the most common symptom
is diarrhea, medication should help alleviate frequency, loose stools, etc. If
the main problem is constipation, then medication should help soften the bowel
movement and increase frequency of bowel habits. Medications of choice fall into
the following categories: Antispasmodics, bulking agents, antidiarrheals,
laxatives, tricyclic antidepressants, serotonin reuptake medications, 5-HT,
antagonists and 5-HT, agonists. The treating physician will choose the
medication most closely associated with alleviating the patient’s IBS symptoms
which should also help with the overall treatment of fibromyalgia symptoms. As
with any comorbid condition in fibromyalgia, it is imperative that symptoms
which can be addressed and remedied are identified. Alleviating these symptoms
can help with the overall quality of life experienced by fibromyalgia patients.
1Lacy, Sean R
(2005). Weiner’s Pain Management, A Practical Guide for Clinicians, 7th
edition, 371-379.
