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Digestive Disorders in Fibromyalgia

Leaky Gut Syndrome

There is a strong correlation between Fibromyalgia, "Leaky Gut Syndrome" (LGS) and Irritable Bowel Syndrome (IBS). In fact, LGS may well be the major contributing factor in many of the symptoms of Fibromyalgia.

The lining of your intestinal tract is called the intestinal mucosa. The mucosa or intestinal lining  is responsible for allowing essential nutrients to be absorbed into your body. It is also a barrier that keeps harmful microorganisms, toxins and by-products of digestion from being absorbed.

The mucosa has a special "glue" known as desmosomes that holds the mucosal cells together. If the desmosomes are damaged, larger sized particles that are not normally absorbed can pass through the mucosa and enter your blood stream. This increased permeability in the intestinal mucosa, or LGS, can set up a cascade of events that can cause many of the symptoms present in Fibromyalgia. Below are the symptoms known to occur in LGS:

• fatigue
• joint and muscle pain (arthralgias and myalgias)
• fevers of unknown origin
• food intolerance
• abdominal pain or distension
• diarrhea
• skin rashes
• toxic feelings
• cognitive and memory deficits (Fibro Fog)
• shortness of breath

poor exercise tolerance

The appearance of these symptoms is due to two processes that occur after increased mucosal permeability. The first is an immune system response. Your immune system recognizes the invading particles "non-self." Your immune system then responds by attacking them also by producing antibodies. This puts an additional load on your immune system.

The second way that increased permeability adversely affects your body is by the stress that the abnormally absorbed particles place on your liver. Your liver is responsible for removing these large molecules, and also to oxidize toxins. This can overload your liver's capacity of detoxification and lead to liver cell damage, excess free radical production, and increased strain on an already dysfunctional immune system.

A paradox in LGS is that while harmful particles are allowed though the compromised intestinal mucosa, essential nutrients are not absorbed adequately. Normal nutrient depends on the integrity of the intestinal mucosal cells. Disruption of mucosal cells results in diminished effectiveness of certain carrier proteins that transport minerals such as magnesium and zinc. Therefore, a total body magnesium deficit is often seen in Fibromyalgia, even in those who take mineral supplements. The same can be true for zinc. The end result in LGS is a vicious cycle of harmful particles being inappropriately absorbed, and essential nutrients not being absorbed.

Irritable Bowel Syndrome

The incidence of Irritable Bowel Syndrome (IBS) in Fibromyalgia is very high. Some studies suggest up to a 70% association between the two, hence the nickname "Fibrogut."

The gastrointestinal (GI) tract has layers of muscle that churn and mix nutritive elements with digestive juices and propel the foodstuff forward. IBS symptoms appear when the cells in the GI tract do not form enough energy. This decreased cell energy level leads to a decrease in the churning and propelling function, and the bowel consequently behaves "irritably."

IBS symptoms include the buildup of gas, sieges of diarrhea, constipation, bloating, and pain. In addition, there may be symptoms related to the upper gastrointestinal tract such as non-cardiac chest pain, heartburn, difficulty in swallowing, and a feeling of fullness in the throat.

Disruption of Intestinal Flora

With digestive disorders, there is a very real possibility of having a disruption of the intestinal "flora," the bacteria normally present in the lower intestine. As a general rule, there are relatively few bacteria in your upper or small intestine, but your lower intestine is literally packed with bacteria. These bacteria have a tremendous influence on both intestinal health and overall health. These bacteria are essential for nutrient absorption. Their presence also helps keep unfriendly microbes in check, and they support overall healthy bowel function.

Unfortunately there are many things that can disrupt your normal intestinal flora's composition. These include dietary habits (especially a diet too high in sugar), excessive alcohol consumption, the use of the non-steroid anti-inflammatory drugs (the NSAIDS), which virtually all people with Fibromyalgia take, and the use of antibiotics, to list a few. Antibiotics kill off all bacteria, including the "good" kind. This leads to an imbalance, allowing an overgrowth of the "bad" kind.

Whatever the cause of the disruption of the normal flora, the consequences can be severe, and include the following:

• chronic fatigue
• frequent diarrhea
• Chronic constipation
• gas and cramping
• decreased immune responsiveness
• increased bladder infections
• chronic vaginal infections
• vitamin B deficiencies
• low sex hormones
• chronic anemia
• breast enlargement in men
• prostate symptoms
• increased menstrual pain
• intensified PMS symptoms
• Mineral Deficiencies

The support of your body's normal intestinal flora or the re-establishment of an altered flora is extremely important in the reversal of Fibromyalgia.

Small Intestinal Bacterial Overgrowth

In addition to Irritable Bowel Syndrome (IBS) and Leaky Gut Syndrome (LGS), there is another complicating factor that can enter the picture. In a recent study published in "The American Journal of Gastroenterology," it was found that 78% of the study group who had been diagnosed with IBS had something called Small Intestinal Bacterial Overgrowth (SIBO).

The small intestine doesn't normally have harmful bacteria. In a normal gastrointestinal tract, the acid and motility (ability of the intestines to propel food forward) prevents this from occurring. When this is disrupted, SIBO can develop. This SIBO can cause symptoms, which can both mimic and intensify the abdominal discomfort found in many people with Fibromyalgia.

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