Are you struggling with fibromyalgia and also dealing with irritable bowel syndrome (IBS) or other digestive issues? You’re not alone. Studies suggest that up to 70% of people with fibromyalgia also have an IBS diagnosis and many others experience digestive symptoms.
Research has shown that the gut microbiome in people with fibromyalgia look different from healthy people. These imbalances may contribute to symptoms and make fibromyalgia harder to manage.
What I’ve Seen in My Fibromyalgia Clients
In my practice, I’ve noticed that most of my fibromyalgia clients have some level of gut imbalance, known as dysbiosis. Many also have small intestinal bacterial overgrowth (SIBO), which can further complicate symptoms. Addressing gut health is a key part of helping them feel better.
The Gut-Brain-immune Axis and Chronic Pain Syndromes
In recent years, there has been building research into the gut-brain-immune connection, including how the microbiome (or imbalance of it) relates to chronic pain syndromes, like fibromyalgia and complex regional pain syndrome.
Our gut microbiome, the community of microbes living within us, plays a crucial role in the health of our nervous system. These microbes communicate with both the brain and peripheral nervous system through nerve pathways, as well as by producing hormones, enzymes, and other bioactive compounds. This tight connection means that changes in gut health can directly impact brain function, mood, and even pain perception.
Your gut bacteria also produce compounds that support immune function and help maintain a strong gut barrier, regulate inflammation and preventing unwanted substances from triggering immune reactions.
Researchers have found that people with these conditions have a different balance of gut bacteria compared to those without. This imbalance, known as dysbiosis, is linked to increased pain severity, making symptoms more difficult to manage.
How Gut Health Affects Pain
Below are just some of the ways a disruption in the gut-brain-immune axis can contribute to the development or poor management of fibromyalgia and persistent pain:
- Neurotransmitter Disruptions: Overgrowth or imbalances of harmful bacteria can interfere with neurotransmitter production like GABA, serotonin and acetylcholine, which influence pain, mood and fatigue levels.
- Intestinal Barrier Function: Changes in gut bacteria can weaken the intestinal barrier, which normally absorbs nutrients while keeping harmful substances out. When this barrier is compromised, toxins can enter the bloodstream, triggering immune reactions and inflammation, a condition often referred to as “leaky gut syndrome.”
- SIBO and Inflammation: SIBO (small intestinal bacterial overgrowth) occurs when too many bacteria grow in the small intestine, disrupting gut-brain communication. This can lead to symptoms like bloating, pain, diarrhea, fatigue, and even anxiety or depression, symptoms
which overlap with fibromyalgia. - Mitochondrial Dysfunction: Bacterial by-products like D-lactate and hydrogen sulfide can interfere with energy production in cells, leading to fatigue and muscle pain. Conversely, the production of short chain fatty acids (SCFA’s) by bacteria positively supports mitochondrial function.
- Food Sensitivities: Compromised gut health can lead to new food intolerances and sensitivities, which may increase inflammation and worsen pain.
How to Start Healing Your Gut
Diet is the biggest influencing factor when it comes to having a healthy microbiome. Here’s a few simple tips to get you started.
- Include a variety of colourful fresh fruits and vegetables daily
- Avoid or limit refined sugars and grains
- Avoid or limit preservatives, additives and artificial sweeteners
- Aim for 30g of fibre daily
- Include fermented foods in your diet regularly
If you already have a fibromyalgia or IBS diagnosis, then a more personalised approach will likely bring you the best results. The first step is a thorough assessment and guidance from a knowledgeable practitioner.
While not always necessary, functional testing, such as a SIBO breath test, microbiome stool test, or PCR parasitology test, can be a useful tool to help identify imbalances alongside detailed case taking by your practitioner. Your naturopath or nutritionist can refer you for these tests, help you understand the results, and develop a plan of attack for addressing any abnormalities that are found.
Taking Steps Toward Relief
Managing fibromyalgia isn’t just about reducing pain, it’s about improving your overall well-being. Supporting your gut with the right diet, herbs, nutrients or probiotics can lead to real improvements in how you feel every day.
You don’t have to do this alone. If you’re ready to explore how gut health could be impacting your fibromyalgia, reach out to book a 1:1 consultation. Let’s work together to help you feel better and regain control of your health.
