Research suggests there may be a link between fibromyalgia and irritable bowel syndrome (IBS). However, more research is needed to verify the exact connection.

Fibromyalgia is a disorder of the nervous system. It leads to symptoms such as pain, chronic fatigue, and insomnia.

IBS is a localized gastrointestinal disorder that causes abdominal pain, constipation, and diarrhea.

This article discusses the link between fibromyalgia and IBS. It also goes over the symptoms and treatments for each condition.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Fibromyalgia occurs in up to 60% of people with IBS, and up to 70% of people with fibromyalgia have symptoms of IBS.

IBS with mixed constipation and diarrhea and IBS with constipation are the predominant types that appear in people with fibromyalgia.

Fibromyalgia and IBS have various factors in common, including the following:

  • both primarily occur in females
  • both include symptoms such as fatigue and insomnia
  • symptoms can be misunderstood
  • stress can trigger or worsen symptoms
  • effective treatments can involve psychotherapy
  • similar medications can effectively manage symptoms
  • there is no known cure at this time for either condition

Although current research suggests IBS is common among people with fibromyalgia, more research is needed on the exact connection between the two conditions.

While there may be a link between fibromyalgia and IBS, the symptoms of each condition can vary.

Fibromyalgia symptoms

A person with fibromyalgia may experience:

IBS symptoms

An individual with IBS may experience:

There is currently no cure for either fibromyalgia or IBS.

Treatments focus on symptom management and improving quality of life. Options include medications, lifestyle changes, and psychotherapy.

Medications for fibromyalgia and IBS

Medications for fibromyalgia and IBS can help manage pain and muscle spasms, regulate bowel movements, improve sleep, and stabilize mood.

Pain relievers

Pain relievers that can help manage fibromyalgia and IBS include:

Other prescription nonsteroidal anti-inflammatories (NSAIDs) may include diclofenac, celecoxib (Celebrex), or indomethacin (Indocin).

Doctors may also recommend opioids to help manage fibromyalgia pain. However, overall, they do not believe them to be effective at managing fibromyalgia pain over time.

Of all the opioid medications available, doctors have used tramadol (Ultram) most often for fibromyalgia relief. This is because it may act as an opioid and a serotonin-norepinephrine reuptake inhibitor (SNRI).

Opioids are not the first choice for pain control in fibromyalgia, and more research is needed into their use.

Anticholinergic medications

Anticholinergic medications work by blocking protein receptors called muscarinic receptors from the neurotransmitter acetylcholine. Neurotransmitters are chemical messengers in the body.

Blocking the muscarinic receptors from acetylcholine stops muscle spasms in the gut, causing them to relax.

The medications doctors specifically use to manage IBS-related muscle spasms include Hycosamine (Levsin, NuLev, Levbid) and Dicyclomine (Bentyl).

Regulate bowel movements

Medications can help relieve constipation with IBS.

Fiber supplements may help prevent constipation, while laxatives may treat constipation associated with IBS. Each type works differently, so it may take a combination of medications to find an effective treatment.

Medications to help manage IBS-related constipation include:

  • fiber supplements (psyllium)
  • magnesium hydroxide (Philips’ Milk of Magnesia)
  • polyethylene glycol (Miralax)
  • bisacodyl (Dulcolax)
  • senna (Senokot)

Doctors can use medications that help stool to form and have a firmer consistency to treat diarrhea or stool leakage associated with IBS. These work by reducing the amount of liquid in the stool.

Medications for diarrhea include:

Antiepileptic medications

Also known as anti-seizure medications, antiepileptics can help with various fibromyalgia symptoms, such as pain, anxiety, and sleep issues.

The two most common antiepileptic medications for fibromyalgia are pregabalin (Lyrica) and gabapentin (Neurontin). Neurontin is not approved for treating fibromyalgia, so doctors use it off-label for this purpose.

Antidepressant medications

Antidepressants can help manage pain associated with fibromyalgia. They can also help with depression and anxiety that may co-occur with fibromyalgia.

Antidepressants to help manage symptoms of fibromyalgia include:

The use of antidepressants for fibromyalgia has many benefits. However, potential risks are also involved, such as weight gain and possible suicidal thoughts. It is important for people to speak with their doctor about all the risks and benefits.

Antidepressants to treat IBS work by blocking signals from the gut to the brain. The most common tricyclic antidepressants for IBS include:

Natural treatments for fibromyalgia and IBS

There are also various nonpharmacological ways to help manage both IBS and fibromyalgia. These include:

It may be best to speak with a healthcare professional before trying these or other natural treatments.

The following are answers to questions people commonly ask about fibromyalgia and IBS.

Why might people with fibromyalgia have IBS?

The exact relationship between fibromyalgia and IBS is unknown. However, several factors may contribute to the co-occurrence of these two conditions. These include the following:

  • both conditions involve increased sensitivity to pain and overstimulation of the central nervous system
  • people who experience them often have atypical regulation of certain hormones and neurotransmitters, such as serotonin and dopamine, as well as disturbances in the gut-brain axis, the connection between the gut and the central nervous system
  • there may be a genetic component to both
  • psychological factors and extreme stress may play a role in both conditions

How does fibromyalgia affect the bowels?

Fibromyalgia can cause increased sensitivity with an increased pain experience, which can be tied to IBS symptoms. People with fibromyalgia often have gastrointestinal problems, which may include:

  • abdominal pain
  • bloating
  • constipation and diarrhea
  • stool leakage

What are the most severe symptoms of fibromyalgia?

Although each person’s experience and symptoms of fibromyalgia vary greatly, the most severe symptoms of fibromyalgia include:

  • generalized, widespread pain
  • debilitating fatigue
  • memory issues and brain fog
  • insomnia
  • symptoms of IBS

Fibromyalgia and IBS have similar clinical characteristics and a significant overlap of individual-reported symptoms. Researchers are still looking for a definitive connection.

Even though the exact link remains unknown, researchers have found a relationship between the two conditions. A large majority of people with fibromyalgia also experience IBS or IBS-related symptoms.

Treatment for the two conditions also overlaps. It is best for individuals with fibromyalgia who are experiencing digestive issues to speak with a healthcare professional.