Studies Now Connect Fibromyalgia to SIBO

Several studies now tie fibromyalgia back to the gut. There is a strong relationship between fibromyalgia and bacterial overgrowth in the small intestine, a condition known as SIBO, or small intestine bacterial overgrowth. (2)(3)
One study that was published in Annals of the Rheumatic Diseases in 2004 found a 100% correspondence of Fibromyalgia with SIBO. (4)
Researchers have finally linked Fibromyalgia to the health of the gut! One study showed a 100% connection between fibromyalgia and small intestine bacterial overgrowth, the direct result of an imbalanced inner ecosystem.

In a double blind study, participants were asked to take a lactulose breath test, the gold standard when it comes to measuring overgrowth in the small intestine, which checks the breath for the presence of hydrogen. Bacteria produce hydrogen gas or methane as they feed.

Researchers at the Cedars-Sinai Medical Center found that 100% of the participants with fibromyalgia had abnormal test results. They also found that the more abnormal the test results, the more pain a fibromyalgia volunteer was in.

The degree of bacterial overgrowth in the small intestine has a direct relationship with the severity of fibromyalgia.

I have put together a SIBO Video E course where you can learn more here

The Development of Small Intestine Bacterial Overgrowth (SIBO)

When bacteria overrun the small intestine, whether good or bad bacteria, problems quickly arise. This is because the small intestine is meant to smoothly shuttle food from one end of the digestive tract to the other.

How things can go wrong:

Enzymes play an important role. If there are not enough of the right enzymes in the small intestinal tract, which are known as brush-border enzymes, food slows its transit time, and bacterial populations begin to grow.
Diet also matters. When we eat a carb-heavy meal, or if we are unable to break down certain plant fibers, this feeds resident bacteria.
The wrong kind of bacteria starts to grow. Whether its food poisoning or a small, resident populace of disease-causing microbes, these bad bugs can actually secrete an opiate-like substance that will slow down the wave-like motion of the small intestine. This gives food a chance to rot and ferment and microbial communities the opportunity to grow.
Diabetes and hypothyroidism affect digestion. In both diabetes and hypothyroidism, something known as the migrating motor complex slows down. The migrating motor complex (MMC) is a set of wave-like movements that keeps food and bacteria moving. Oftentimes, bacteria from the large intestine creep up into the small intestine. With a robust MMC in place, this is usually not a problem. When the MMC weakens or slows down, these bacteria are given the opportunity to proliferate and dysbiosis occurs.

Communities of bacteria in the small intestine and throughout the intestinal tract are normal and expected. It is only when these communities get out of control that problems arise. In any healthy ecosystem, balance is key.

Bacterial Overgrowth May Lead to Fibromyalgia

Once our inner ecosystems reach a state of imbalance (dysbiosis), the intestinal lining can become “leaky,” or permeable. This becomes a problem because bacteria produce their own toxins and waste products.

These are toxins like:

Lipopolysaccharide (LPS): Otherwise known as endotoxin, this molecule gives structural support to certain bacteria. It also elicits a strong response from our immune system.

Endotoxins contribute to inflammation in the body. We also know that in fibromyalgia patients, it leads to increased pain. (5)

Tryptophanase: Another by-product of some bacteria is an enzyme that degrades or breaks down tryptophan. Tryptophan is an amino acid that gets quite a bit of attention because it acts as a precursor to serotonin. Without tryptophan, serotonin (our happy brain chemical) could not be made. And without serotonin, it is pretty difficult to manufacture melatonin (our sleepy brain chemical).

Serotonin helps us feel relaxed and happy. It is also important for gut motility, the migrating motor complex that we mentioned earlier. Serotonin deficiency contributes to pain, carbohydrate cravings, constipation, Brain fog and fatigue.

Melatonin helps us fall asleep easily. It also helps to reboot our energy on a cellular level and new studies it also plays a role in relaxing abdominal cramping.

When large amounts of the enzyme tryptophanase are busy breaking apart tryptophan, the body no longer has the building blocks that it needs to make enough serotonin and melatonin.

This contributes to fibromyalgia syndrome.