Increased Frequency of Gastrointestinal Symptoms in Patients with Fibromyalgia and Associated Factors: A Comparative Study

Published: July 12, 2012

Ömer Nuri Pamuk
Hasan Ümit
Orbay Harmandar

Author Affiliations

  1. From the Departments of Rheumatology, Gastroenterology, and Internal Medicine, Trakya University Medical Faculty, Edirne, Turkey.
  2. Ö.N. Pamuk, MD, Associate Professor in Rheumatology, Department of Rheumatology; H. Ümit, MD, Assistant Professor in Gastroenterology, Department of Internal Medicine; O. Harmandar, MD, Resident-in-Chief, Department of Internal Medicine, Trakya University Medical Faculty.

* Address correspondence to Dr. Ö.N. Pamuk, Trakya University Medical Faculty, Department of Rheumatology, Edirne, 22030, Turkey. E-mail:



To determine the frequency and severity of gastrointestinal (GI) symptoms in patients with fibromyalgia (FM).


We included 152 women with FM (mean age 45.4 ± 12.2 yrs), 98 women with rheumatoid arthritis (RA; mean age 45.5 ± 12.3 yrs), and 60 healthy female controls (mean age 44 ± 11.3 yrs). All patients were questioned about the severity of their chronic widespread pain, symptoms of FM, symptoms of dyspepsia, using a visual analog scale (VAS), and anxiety-depression scale. Patients were asked self-reported (yes/no), symptom-based (= 2 criteria) constipation and severity of constipation questions, and about the severity of quality of life (QOL) disturbance secondary to dyspepsia and constipation.


Patients with FM had higher symptom severities for belching, reflux, bloating, sour taste, and vomiting than patients with RA and controls (all p values < 0.01). Patients with FM had significantly more dyspepsia-related QOL disturbances than the other 2 groups (p < 0.01). FM and RA patients had more frequent self-reported constipation than controls (respectively, 42.1%, 48%, 21.7%; p < 0.01). The frequency of symptom-based constipation was significantly higher in the RA group (49%) than in FM (29.6%) and control groups (23.3%) (p < 0.01). Constipation-related QOL disturbance was significantly higher in patients with FM than in controls (p < 0.01).


In patients with FM, the severity scores of dyspepsia symptoms, constipation, and dyspepsia-related QOL disturbance were higher than in patients with RA and controls. The higher GI symptom severity in patients with FM might have negative effects on their QOL.


Published online before print June 30, 2009, doi: 10.3899/jrheum.090024 The Journal of Rheumatology August 1, 2009 vol. 36 no. 8 1720-1724

See the abstract online at The Journal of Rheumatology.

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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