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Abstract
An association between irritable bowel syndrome (IBS) and small intestinal bacterial
overgrowth (SIBO) has been found.
To compare the prevalence and test results for bacterial overgrowth between IBS and
fibromyalgia.
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.
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).
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.