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Small Intestinal Bacterial Overgrowth: A Possible Association with Fibromyalgia

Objectives: Subjects with fibromyalgia [FMS] frequently have non specific bowel complaints similar to subjects with small intestinal bacterial over growth [SIBO]. The aim of this study was to test whether 1. SIBO is prevalent in FMS and 2. If treatment of SIBO reduces bowel symptoms. Methods: Of 815 subjects under going lactulose hydrogen breath testing for assessment of SIBO, 123 patients had FMS. Those with SIBO were treated with antibiotics. At the initial and follow-up visits, subjects were asked to rate their symptoms. Symptom scores be fore and after treatment were com pared. Results: Of the 123 subjects with FMS, 96 [78%] were found to have SIBO. Returning subjects reported a 57 ± 29% over all improvement in symptoms with significant improvement in bloating, gas, abdominal pain, diarrhea, constipation, joint pains, and fatigue [P < 0.05]. Conclusions: 1. Small intestinal bacterial over growth is associated with FMS, 2. Eradication of SIBO improves intestinal symptoms in FMS.