Breath Test Links Fibromyalgia and Irritable Bowel Syndrome

April 7, 2004

NEW YORK (Reuters Health) Mar 29 - An abnormal lactulose breath test (LBT),

indicative of small intestinal bacterial overgrowth, in fibromyalgia

patients and in irritable bowel syndrome (IBS) patients may help to explain

common features of the conditions, researchers report in the April issue of

the ls of the Rheumatic Diseases.

Dr. Mark Pimentel from Cedars-Sinai Medical Center, Los Angeles, California

and colleagues note that nearly a third of fibromyalgia patients in some

studies are also diagnosed with IBS, suggesting a causal link between the

two disorders.

The researchers tested their hypothesis that the lactulose breath test would

be abnormal in both IBS and fibromyalgia by performing the test in 42

fibromyalgia patients, 111 IBS patients, and 15 healthy controls.

All 42 patients with fibromyalgia had an abnormal LBT, compared with 93

(84%) of IBS patients and 3 (20%) of the controls.

Hydrogen production was significantly greater in fibromyalgia patients than

in IBS patients or healthy controls. Moreover, the researchers note that in

41 fibromyalgia patients, there was a significant correlation between their

visual analogue pain score and the peak hydrogen level and hydrogen area

under the curve seen on the LBT.

" The additional finding in our study that the degree of pain in fibromyalgia

seems to correlate with the degree of hydrogen suggests a possible link

between the LBT findings and hyperalgesia, " the investigators write.

" This study suggests that an abnormal LBT may be a common link between

subjects with fibromyalgia and IBS, " the authors conclude. " Further study is

needed to determine if treatment and normalization of the breath test with

antibiotic treatment can produce an improvement in fibromyalgia in addition

to bowel complaints. "

Ann Rheum Dis 2004;63:450-452.

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