Fibromyalgia Common in People With IBD

Patients with inflammatory bowel disease (IBD) have higher rates of fibromyalgia (FM) than the general population and in previous literature, according to new research.1 Notably, this population experienced higher rates of fatigue and reduced quality of life.

"IBD patients often experience extraintestinal manifestations, which significantly impact their quality of life, contribute to disability, and impose substantial costs on healthcare systems. Osteoarticular manifestations are the most common type of extraintestinal manifestations (EIMs). FM, the second most common rheumatic disease, affects an estimated 2% to 8% of the global population, with a higher prevalence among females. FM is characterized by widespread pain, frequently accompanied by fatigue, cognitive difficulties, and sleep disturbances. Evidence indicates a strong association between FM and IBD, with numerous studies reporting a higher prevalence of FM among IBD patients compared to the general population2,” lead investigator RDCP Prado, University of São Paulo School of Medicine, Department of Gastroenterology and Nutrology, São Paulo, Brazil, and colleagues wrote.1

Prado and colleagues conducted a cross-sectional analysis from adult patients seen at the IBD outpatient clinic at the University of São Paulo from July 2023 to July 2024. FM diagnoses were made based on the 2016 American College of Rheumatology criteria. The investigators collected data on demographics, IBD phenotype, clinical and endoscopic activity, quality of life (IBDQ) and fatigue (FACIT) measurements.

Prado and colleagues included 250 patients in the study. These participants had an overall prevalence of FM of 15.2%, predominantly in female participants (53.6%; P <.001). At the time of inclusion, participants had a mean age of 34.5 years (standard deviation [SD], 15.3) and a mean disease duration of10.9 years (SD, 8.1). Most participants were White (55.7%) and non-smokers (65.3%).1

The investigators found no significant differences in C-reactive protein levels between IBD-FM patients and IBD-only patients (5.1 vs. 8.6 mg/dL; P = .324). Patients with ulcerative colitis had higher rates of FM compared to those with Crohn disease (22 vs 16, P = .041). Patients with FM were statistically significantly older (40.7 years vs. 33.4 years; P = .008) and had a higher BMI (27.8 vs. 24.8; P = .001) compared to those without FM. Prado and colleagues also found that patients with FM had a significantly longer mean disease duration (14 years vs 10.3, P = .015) and reported notably lower mean scores of IBDQ (147.4 vs 183.1; P < .001) and lower mean FACIT scores (31.5 vs 42.1; P < .001) compared to patients without FM.1

“The association between FM and IBD was substantial in the studied cohort, with a prevalence exceeding that reported in the general population and in previous literature. There was a slight predominance of FM among female patients diagnosed with UC. The co-occurrence of IBD and FM was associated with a significantly reduced quality of life and elevated levels of fatigue,” Prado and colleagues concluded.1

REFERENCES

1. Prado RDCP, Domiciano DS, Mattos PSLD, et al. Fibromyalgia as a predictive factor of fatigue and reduced quality of life in patients with inflammatory bowel disease. J Crohn's Colitis. 2025(19):1: i859. doi: 10.1093/ecco-jcc/jjae190.0549

2. Kocyigit BF, Akyol A. Fibromyalgia syndrome: epidemiology, diagnosis and treatment. Reumatologia. 2022;60(6):413-421. doi: 10.5114/reum.2022.123671