E2 ModerateModerate confidencePEM not requiredCross-SectionalPeer-reviewedMachine draft
Prevalence of Fibromyalgia and Chronic Fatigue Syndrome among Individuals with Irritable Bowel Syndrome: An Analysis of United States National Inpatient Sample Database.
Tarar, Zahid Ijaz, Farooq, Umer, Nawaz, Ahmad et al. · Biomedicines · 2023 · DOI
Quick Summary
This study looked at hospital records from 2016-2019 to see how often people with irritable bowel syndrome (IBS) also have fibromyalgia or ME/CFS. Researchers found that people with IBS are about 5 times more likely to have fibromyalgia and about 5 times more likely to have ME/CFS compared to people without IBS. Women, older adults, and white patients were at higher risk for both conditions.
Why It Matters
This study demonstrates a strong statistical link between IBS and ME/CFS, suggesting shared underlying mechanisms or risk factors between these conditions. Understanding these associations may help clinicians recognize patients at higher risk and could inform research into common pathophysiological pathways affecting the gastrointestinal and immune systems in ME/CFS.
Observed Findings
- Among 1,256,325 hospitalized IBS patients, 10.73% (134,890) had ICD-10 codes for fibromyalgia and 0.42% (5,220) had codes for CFS.
- Fibromyalgia and CFS were significantly more prevalent in IBS patients compared to the general population (AOR 5.33 and 5.40, respectively).
- Female gender was a strong independent predictor of fibromyalgia (AOR 11.2) and CFS (AOR 1.86) in IBS patients.
- White race and advancing age were independent predictors of increased odds for both fibromyalgia and CFS in IBS patients.
Inferred Conclusions
- IBS is associated with substantially elevated prevalence of fibromyalgia and CFS, suggesting shared pathophysiological mechanisms or common risk factors across these somatic disorders.
- Demographic factors, particularly female gender, significantly increase the risk of developing fibromyalgia and CFS among IBS patients.
- The multiple IBS subtypes (diarrhea, constipation, mixed) show independent associations with fibromyalgia and CFS, suggesting the relationship extends across IBS phenotypes.
Remaining Questions
- Does IBS precede and potentially increase risk for developing ME/CFS, or does ME/CFS increase susceptibility to IBS symptoms?
- What are the shared biological mechanisms connecting gastrointestinal dysfunction, ME/CFS, and fibromyalgia?
What This Study Does Not Prove
This study does not establish whether IBS causes ME/CFS, whether ME/CFS causes IBS, or whether both stem from a common underlying condition—it only shows they frequently co-occur. The reliance on hospital discharge ICD-10 codes may miss many cases, particularly mild ones, and may not capture undiagnosed or misdiagnosed patients. Cross-sectional design means we cannot determine the temporal sequence of symptom onset.
Tags
Symptom:PainFatigue
Method Flag:PEM Not DefinedWeak Case Definition
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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