# IBS Hints at Migraine, Fibromyalgia, and Depression



## Jeffrey Roberts (Apr 15, 1987)

http://www.medpagetoday.com/Gastroenterolo...yndrome/tb/4197IBS Hints at Migraine, Fibromyalgia, and Depression By Peggy Peck, Senior Editor, MedPage TodayReviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. September 28, 2006BOSTON, Sept. 28 -- When a diagnosis of irritable bowel syndrome (IBS) comes to mind, consider migraine, fibromyalgia, and depression as well. Patients with IBS were 60% more likely to have one of those conditions than were those who didn't have IBS, according to J. Alexander Cole, D.Sc., M.P.H., of Boston University, and colleagues, who studied nearly 100,000 IBS patients enrolled in a national health insurance plan. Patients who were treated for IBS were 40% more likely to have depression, 60% more likely to suffer migraine, and 80% more likely to seek treatment for fibromyalgia, they reported in the current issue of BMC Gastroenterology. Dr. Cole and colleagues used a database of medical and pharmacy claims filed from January 1, 1996, through June 30, 2002, to identify 97,593 people who were treated for IBS. They compared the IBS cohort with a random sample of 27,402 who were enrolled in the same health insurance plan. Women comprised about 75% of the IBS cohort and roughly half of the controls. Age ranged from 18 to more than 65 and distribution was similar in both groups. In the IBS cohort the prevalence of having at least one of the three disorders (migraine, depression, or fibromyalgia) was 264 per 1,000, they wrote. By contrast, the prevalence in the control group was 46 per 1,000. In both control and IBS cohorts depression was the most prevalent condition, with a prevalence of 128 per 1,000 among IBS patients and 60 per 1,000 in the controls. Those in the IBS cohort had a pooled prevalence odds ratio of 1.6 for having one of the three conditions (95% confidence interval 1.5-1.7), while the pooled odds ratio for fibromyalgia in the IBS was 1.8 (95% CI, 1.7-1.9). For migraine the IBS patients had a pooled odds ratio of 1.6 (95% CI, 1.4-1.7) and for depression it was 1.4 (95% CI 1.3-1.4). The authors cautioned that relying on medical and pharmacy claims data limited the ability to ascertain clinical characteristics, such as the predominant symptom of IBS -- constipation or diarrhea -- that might confound the relationship they reported. The lack of that information also prevented them from determining whether there was heterogeneity in the prevalence of depression, fibromyalgia, and migraine in the IBS cohort. Primary source: BMC GastroenterologySource reference: Cole JA et al. "Migraine, Fibromyalgia, and Depression Among People With IBS: A Prevalence Study" BMC Gastroenterology 2006, in press. --------------------------------------------------------------------------------Disclaimer The information presented in this activity is that of the authors and does not necessarily represent the views of the University of Pennsylvania School of Medicine, MedPage Today, and the commercial supporter. Specific medicines discussed in this activity may not yet be approved by the FDA for the use as indicated by the writer or reviewer. Before prescribing any medication, we advise you to review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse effects. Specific patient care decisions are the responsibility of the healthcare professional caring for the patient. Please review our Terms of Use. Â© 2004-2006 MedPage Today, LLC. All Rights Reserved.


----------



## overitnow (Nov 25, 2001)

I have been saying for years that I think my IBS is brain based and that those with these other conditions (FM, migraines, and CFS) might want to consider all of these varients of the same, unspecified malfunction. While this is only some kind of statistical analysis, it is a start. (Circulation, anyone?) Mark


----------



## Jeffrey Roberts (Apr 15, 1987)

http://www.webmd.com/content/article/128/116870.htmIrritable Bowel, Pain Syndromes LinkedIBS Patients 60% More Likely to Suffer Fibromyalgia, Migraine, Depression By Daniel DeNoonWebMD Medical News Reviewed By Louise Chang, MDon Thursday, September 28, 2006 Sept. 28, 2006 -- Doctors have long suspected a link between irritable bowel syndrome, pain syndromes, and depression. New data now strongly support this theory.The findings come from data on 97,593 people with irritable bowel syndrome enrolled in a large U.S. health plan from 1996 to 2002. J. Alexander Cole, DSc, MPH, and colleagues at Boston University compared these patients with 27,402 people seeking routine health care.Their results show that people with irritable bowel syndrome are:80% more likely to suffer fibromyalgiafibromyalgia 60% more likely to suffer migraine 40% more likely to suffer depression Overall, 60% more likely to suffer fibromyalgia, migraine, or depression "Perhaps what is driving the relation between irritable bowel syndrome and these other conditions is some underlying biological disorder," Cole tells WebMD. "Nobody is sure what this could be. But people suggest that there is this constellation of symptoms among people with irritable bowel syndrome, fibromyalgia, migraine, and depression that might present in different ways."Cole and colleagues report their findings in the Sept. 28 issue of the online journal BMC Gastroenterology.Common Cause of Pain Syndromes?Cole, now an epidemiologist with i3 Drug Safety, is not an expert on irritable bowel syndrome. Reza Shaker, MD, is. Shaker, chief of gastroenterology and hepatology at the Medical College of Wisconsin, was not involved in the Cole study."Clinical observations of patients with pain syndromes indicate that we are dealing with a syndrome bigger than a single organ," Shaker tells WebMD. "These findings confirm these previous observations."Shaker says people with irritable bowel syndrome and people with pain syndromes such as fibromyalgia and migraine have something in common. They all have nerve pathways which somehow have become vastly oversensitive to pain signals -- a process doctors call sensitization.Perhaps, Shaker suggests, there's a common problem at the crossroads where these nerve pathways intersect."Is it possible that there is an event -- possibly an early life event -- that affects the crossroads of all these nerve pathways?" he asks. "In areas where these nerves cross, it could be that there is sensitization occurring, affecting different neural circuits."Cole suggests that different doctors looking at the same underlying illness might make different diagnoses. A gastroenterologist, for example, might diagnose irritable bowel syndrome, while a rheumatologist might diagnose fibromyalgia.This sounds a lot like the blind men who, on first encountering an elephant, declare it to be like a snake or a tree depending on whether they are touching the elephant's trunk or its leg. Shaker says this analogy is apt. But most doctors, he says, will examine the whole elephant, not just its parts."A professional doesn't just focus on one symptom. If we see irritable bowel syndrome along with noncardiac chest pain or fibromyalgia, then we tackle this," he says. "But we doctors need to have a more global picture of this, instead of pigeonholing our diagnosis according to our own specialty or subspecialty."--------------------------------------------------------------------------------SOURCES: Cole, J.A. BMC Gastroenterology, Sept. 28, 2006; vol 6: pp 26. J. Alexander Cole, DSc, MPH, epidemiologist, i3 Drug Safety. Reza Shaker, MD, chief, division of gastroenterology and hepatology, Medical College of Wisconsin, Milwaukee.Â© 2006 WebMD Inc. All rights reserved.


----------

