Connecting the Dots: Understanding the Link Between Severe Acid Reflux and Fibromyalgia

While it may seem odd that these two conditions are linked together, it turns out that fibromyalgia and gastrointestinal esophageal reflux disease are connected to each other. A recent study has looked at this comorbidity that many patients report having and have found that it is highly likely for fibromyalgia to have symptoms of GERD and that these symptoms can easily worsen a fibromyalgia patient's condition.

For those who may not know, Gastrointestinal Esophageal Reflux Disease (GERD) is a severe form of acid reflux that often results in a number of unwanted and discomforting symptoms. During the period of GERD, the food and acid in the stomach undergo many unpleasant reactions that cause it to begin to rise back into the sufferer’s esophagus. The results of GERD include heartburn, chest pain, and throat sensitivity, and if left untreated, GERD will often result in more severe complications that have a detrimental effect on the health status of the patient.

A study attempted to closely evaluate the relationship between GERD and fibromyalgia, and it features over 35,000 patients who were suffering from both conditions and evaluated a careful comparison to thousands of symptom-free patients without either fibromyalgia or GERD. The result of the study established that comorbidity existed between both complications and reported that patients with fibromyalgia had gastrointestinal disturbances including symptoms like GERD and irritable bowel syndrome. GERD was observed to be characterized by the entry of the gastric acid to the esophagus, lungs, or oral cavity, thereby resulting in heartburn or regurgitations.

Even from the study, an underlying mechanism that clearly establishes the relationship between GERD and fibromyalgia isn’t totally defined, although, studies and testing on animals have suggested that the degree of acidity in the esophagus plays a critical role.

How does GERD develop?

GERD is the result of a culmination of factors which typically comprises of lifestyle and physiological factors. The majority of the cases of fibro-stimulated GERD occur as a result of a challenge with the sphincter situated at the esophagus’ bottom. This Lower Esophageal Sphincter (LES) is required and serves to prevent regurgitations and rising back up of any stomach acid or content into the esophagus. In the course of action, the LES itself can become weakened and may allow the acid and food to reflux into the esophagus while the same may also occur overnight when the LES tends to experience moments of relaxation.

Other factors that can trigger the GERD include weight, general health, and diet. The risk factor for GERD is unevenly distributed among members of the population facing no health issues to their challenged counterparts, most especially in people suffering from fibromyalgia. While the GERD affects men, women, and children across all ages, the case is particularly high and aggravated in people who have fibromyalgia in a ration up to 60 percent. While the causes for this association remain unknown, the risk factors include:

• Fibromyalgia
• Overweight and obesity
• Smoking
• Alcohol consumption
• High acid, spicy or fatty food consumption

Patients suffering from GERD may commonly evaluate the symptom to be simple heartburn and indigestion issues, if the patient is already suffering from fibromyalgia, it may be overlooked as one of the ensuing complications. The symptoms of GERD like fibromyalgia tend to be many and become more severe as the illness progresses. Some of the most common signs of GERD include:

• Heartburn
• Regurgitations
• Dry mouth
• Blood in vomit
• Anemia and other nutritional deficiencies
• Chronic cough
• Pain in the chest or thorax region
• Swallowing difficulties
• Loss in weight

To control GERD symptoms, Patients often use Proton pump inhibitors (PPI) that aid in decreasing the production of gastric acid. While the therapy can be effective, the long-term application of these drug groups can alter the body’s susceptibility to the attack of bacterial pathogens in the gut. Furthermore, magnesium and Vitamin B12 deficiencies, which are regarded as part of the key culprits that lead to fibromyalgia may be experienced. The relationship goes both ways as studies have shown that fibromyalgia patients who are administered the Proton pump inhibitors (PPI) medications may also be at risk of developing the GERD. A more detailed look at the earlier study explains that 35,117 patients who had been diagnosed with fibromyalgia were evaluated against the second group of 34,360 patients with GERD between the period of 2000 and 2010, with the control subjects being free from either symptom of the GERD or fibromyalgia disease. The incidence of the development of GERD in the first group of patients with fibromyalgia and that of the development of fibromyalgia in the second group of GERD patients was altogether evaluated at the end of the year 2011.

The ensuing results concluded that a bidirectional relationship existed, and the overall occurrence of GERD was 1.6 times higher in the fibromyalgia group of 35,117 patients than in the control subjects (who have neither GERD or fibromyalgia), which factored in patients' ages, comorbidities, medications, and sexes. Similarly, the GERD group had 1.5 times more likelihood and incidence of fibromyalgia than the control group.

A closer interpretation of the research results exposes that it took longer for patients with fibromyalgia to develop GERD than the time taken for GERD patients to develop fibromyalgia. These findings have proven very beneficial and may yet be the reason for the higher prevalence of the comorbidities in the GERD group over the fibromyalgia. A correlation was also established with the parameter of age as the study also shows that the incidence of the rates of either disease in the other condition’s group upsurge as the age increased.

The team of researchers further believe that psychiatric comorbidities such as anxiety, depression, stress, and exhaustion as well as lack of physical exercises are among the possible fibromyalgia mechanism that can explain this association. Sleep deprivation, unrest, and mood disorders in GERD may be further adverse effects to fibromyalgia patients and may also intensify the pain.

The altered intestinal permeability of patients with peptic ulcer disease and patients who are being administered non-steroidal anti-inflammatory drugs (NSAIDs) has been shown to contribute a big role to the greater risk of these patients developing fibromyalgia as well.