A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing.

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A link between irritable bowel syndrome and fibromyalgia may be related to

findings on lactulose breath testing.

Ann Rheum Dis. 2004 Apr;63(4):450-452.

Pimentel M, Wallace D, Hallegua D, Chow E, Kong Y, Park S, Lin HC.

GI Motility Program, Divisions of Gastroenterology and Rheumatology,

Department of Medicine, Cedars-Sinai Medical Center, CSMC Burns &

Research Institute, Los Angeles, California 90048, School of Medicine,

University of California, Los Angeles, Los Angeles, California 90024, USA.

PMID: 15020342

BACKGROUND: An association between irritable bowel syndrome (IBS) and small

intestinal bacterial overgrowth (SIBO) has been found.

OBJECTIVE: To compare the prevalence and test results for bacterial

overgrowth between IBS and fibromyalgia.

METHODS: Subjects with independent fibromyalgia and IBS were compared with

controls in a double blind study. Participants completed a questionnaire,

and a lactulose hydrogen breath test was used to determine the presence of

SIBO. The prevalence of an abnormal breath test was compared between study

participants. Hydrogen production on the breath test was compared between

subjects with IBS and fibromyalgia. The somatic pain visual analogue score

of subjects with fibromyalgia was compared with their degree of hydrogen

production.

RESULTS: 3/15 (20%) controls had an abnormal breath test compared with

93/111 (84%) subjects with IBS (p<0.01) and 42/42 (100%) with fibromyalgia

(p<0.0001 v controls, p<0.05 v IBS). Subjects with fibromyalgia had higher

hydrogen profiles (p<0.01), peak hydrogen (p<0.0001), and area under the

curve (p<0.01) than subjects with IBS. This was not dependent on the higher

prevalence of an abnormal breath test. The degree of somatic pain in

fibromyalgia correlated significantly with the hydrogen level seen on the

breath test (r = 0.42, p<0.01).

CONCLUSIONS: An abnormal lactulose breath test is more common in

fibromyalgia than IBS. In contrast with IBS, the degree of abnormality on

breath test is greater in subjects with fibromyalgia and correlates with

somatic pain.