Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome
Abstract
OBJECTIVES: The pain intensity of patients with FM has recently been reported to be correlated with the degree of small intestinal bacterial overgrowth (SIBO). SIBO is often associated with an increased intestinal permeability (IP). Increased IP, if shown in FM, may have pathogenetic relevance because it leads to the exposure of immune cells to luminal antigens and consequent immune modulation. It is currently unknown whether IP is altered in FM. We therefore examined the IP in a group of patients with primary FM and in two control groups, healthy volunteers and patients with an unrelated chronic pain syndrome, complex regional pain syndrome (CRPS). We hypothesized that patients with FM, but not volunteers or those patients with CRPS, would have altered IP. METHODS: Both gastroduodenal and small IP were assessed using an established three-sugar test, where urinary disaccharide excretion reflecting intestinal uptake was measured using HPLC. RESULTS: Forty patients with primary FM, 57 age- and sex-matched volunteers and 17 patients with CRPS were enrolled in this study. In the FM group, 13 patients had raised gastroduodenal permeability and 15 patients had raised small intestinal permeability, but only one volunteer had increased gastroduodenal permeability (P < 0.0001, chi-square test for the three groups). The IP values were significantly increased in the patient groups (P < 0.0003 for all comparisons, one-way analysis of variance). CONCLUSIONS: The IPs in primary FM and, unexpectedly, CRPS are increased. This study should stimulate further research to determine the implication of altered IP in the disease pathophysiology of FM and CRPS.
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Increased intestinal permeability has been described in patients with chronic fatigue syndrome, fibromyalgia, and complex regional pain syndrome.
“Increased intestinal permeability has also been described in patients with chronic fatigue syndrome (CFS),37 fibromyalgia, and complex regional pain syndrome.38”
From The Gut Microbiome and the Brain (2014) · cites this paper as [38]
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- Authors
- Goebel, A., Buhner, S., Schedel, R., Lochs, H., & Sprotte, G.
- Affiliations
- Universitätsklinikum Würzburg (DE)
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-04-29
- Volume
- 47
- Issue
- 8
- Pages
- 1223-1227
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- OpenAlex
- W2140690831
- Cited by
- 76
- References
- 46
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 6 · 2014: 7 · 2013: 5 · 2012: 3
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- intestinal permeability, primary fibromyalgia, complex regional pain syndrome, small intestinal bacterial overgrowth, chronic pain, immunomodulation
- MeSH terms
- Adult, Female, Fibromyalgia, Gastric Mucosa, Humans, Intestinal Absorption, Intestine, Small, Male, Middle Aged, Pain Measurement, Permeability, Complex Regional Pain Syndromes
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