People with fibromyalgia (FM) have different quantities of certain types of gut bacteria than those without the disease, according to a new study published in the journal PAIN. It’s the first time differences in the gut microbiome have been linked to the disease, and the researchers say their work may lead to better diagnostic tools and treatment options.
Fibromyalgia is one of the most common forms of chronic widespread pain, affecting as much as 4 percent of the population. It is characterized by pain, physical exhaustion, sleep problems, and cognitive symptoms that affect a person’s overall quality of life. The source and cause of the disease are largely unknown and it’s difficult to diagnose, in some cases taking up to five years to do so.
Researchers tested 77 women with FM and 79 control participants in a variety of ways, including extracting DNA from stool samples.
"We found that fibromyalgia and the symptoms of fibromyalgia – pain, fatigue, and cognitive difficulties – contribute more than any of the other factors to the variations we see in the microbiomes of those with the disease,” said study author Amir Minerbi in a statement. “We also saw that the severity of a patient's symptoms was directly correlated with an increased presence or a more pronounced absence of certain bacteria – something which has never been reported before."
Generally speaking, those with and without FM had the same overall population and diversity of bacteria in the gut microbiome, but their levels differed. In all, 19 different species of bacteria – including several that have been linked to gut disorders, inflammatory arthritis, and inflammatory responses – were found in lesser or greater quantities in the gastrointestinal tracts of the study participants with FM.
It’s not clear whether the changes in a person’s gut bacteria are markers of the disease or cause it, but understanding the makeup of the gut microbiome is an important step to understanding how the disease works.
"We used a range of techniques, including Artificial Intelligence, to confirm that the changes we saw in the microbiomes of fibromyalgia patients were not caused by factors such as diet, medication, physical activity, age, and so on, which are known to affect the microbiome," said Minerbi.
Machine learning was then used to analyze the data and accurately diagnose fibromyalgia 87 percent of the time. As of now, there is no test for FM and its diagnosis is largely based on self-reported symptoms.
The researchers report that their next steps will be to determine whether changes in the gut microbiome affect chronic pain.