The FIDGIT Study: an investigation into the relationships between the symptoms of Fibromyalgia, Digestive function, and the microbiome of the Gastrointestinal Tract

Abstract

Fibromyalgia is a common idiopathic chronic pain condition that is almost ten times more common than rheumatoid arthritis. However, it is one of the least researched rheumatological conditions. The high co-prevalence of digestive problems that are now categorised as disorders of gut-brain interaction (DGBI) adds to the difficulties people with fibromyalgia face having their complaints taken seriously. A paucity of effective treatments poses additional challenges for those with the condition.

Research linking the microbiome of the human gut with a range of pathologies – gastrointestinal and extra-gastrointestinal – is accumulating. To date, there are few studies examining associations between the gut microbiome and fibromyalgia.

Therefore, the primary aim of this thesis was to investigate the relationships between the common symptoms of fibromyalgia and the digestive disorders collectively called DGBI, and the microbiome of the gastrointestinal tract.

In addition to comparing clinical features evident in the group of women with fibromyalgia (n = 113) with age-matched controls (n = 55), relationships between these features were examined. Novel findings were significantly poorer oral health scores in the fibromyalgia group, which were associated with DGBI, which were also associated with more severe presentation of fibromyalgia symptoms.

Significant differences were found between oral microbiota and measures of pain, and a range of clinical characteristics in women with fibromyalgia, particularly DGBI.

Differences in faecal microbiota were associated with a range of clinical measures, including cognition, sleep, and DGBI.

New insights are provided in linking the complexity of fibromyalgia with oral health, which has been overlooked in this population until now. Together, the results add to the current knowledge base, invite a new hypothesis and provide a basis for further exploration of this enigmatic condition.