While we think of fibromyalgia as a condition involving painful muscles and joints, the majority also have abdominal complaints, most commonly irritable bowel syndrome (IBS) symptoms: bloating, discomfort, diarrhea, urgency, and also constipation. Fatigue, moodiness, depression, disrupted sleep, mind “fog” and forgetfulness, heightened pain perception are also common.
Small intestinal bacterial overgrowth, SIBO, on the other hand represents a situation in which microorganisms, normally confined to the colon proliferate up along the entire length of the ileum, jejunum, duodenum, even stomach, a full-length infection of the intestinal tract. Microbial species responsible for SIBO are largely pathogenic Enterobacteriaceae such as E. coli. SIBO shares the same symptoms as IBS with added fat malabsorption (see fat droplets in the toilet), new food intolerances, skin rashes, and long-term potential for diverticular disease and colon cancer. Testing for hydrogen release through breath testing is the most commonly used test to diagnose SIBO.
A study published by Dr. Mark Pimentel while at Cedars-Sinai Medical Center in Los Angeles demonstrated that, while 20% of control participants showed a positive H2 test for SIBO (!!), 84% of those with IBS tested positive. Of the participants with fibromyalgia, however, 100% tested positive and were positive to a severe degree:
I have seen fibromyalgia symptoms partially improve with wheat/grain elimination, vitamin D restoration, and basic efforts to cultivate bowel flora. But now I am witnessing complete relief from fibromyalgia with management of SIBO, as Dr. Pimentel’s data would suggest. I don’t know what percentage of people with fibromyalgia will obtain complete relief by managing their SIBO. But, even if not 100% effective, people with SIBO still need to have this condition corrected.
If management of SIBO is the answer to fibromyalgia—and I believe it is—it will help people get off the horrible drugs typically prescribed for this condition like Cymbalta and Lyrica. Cymbalta, for instance, is commonly associated with mind “fog,” anger, suicidal thoughts, and potential for liver damage. Lyrica is associated with flagrant weight gain, impaired memory, sleepiness, and blurred vision. Management of SIBO, in comparison, can be accomplished with little cost and is associated with relief from IBS symptoms, skin rashes, improved nutrient absorption, reduced body-wide inflammation, and reduced long-term potential for diverticular disease and colon cancer, in addition to potential fibromyalgia relief.
Most doctors remain unaware of the widespread prevalence of SIBO that I believe is as common as type 2 diabetes and overweight/obesity. Most are also unaware of the relationship of SIBO with fibromyalgia, as well as IBS. In the Undoctored Inner Circle, we have therefore been helping people identify, then manage their SIBO with success without their doctors, true to our Undoctored philosophy. And I believe that, by adding some new strategies, we are beginning to have an impact on recurrences (recurrent SIBO is a perennial problem) with less recurrences over time.