Understanding the Link Between Fibromyalgia & GERD: Symptoms & Management

Fibromyalgia on its own is a challenging condition to manage. The discomfort of acid reflux or GERD (gastroesophageal reflux disease) may exacerbate the persistent pain characteristic of fibromyalgia

Current studies indicate a complex interconnection between these two conditions, with the potential for each to worsen the other's effects. In this article, we will explore the significant overlap between fibromyalgia and GERD. We will break down the symptoms, and causes and offer strategies for managing both these conditions.

What is fibromyalgia?

Many people with fibromyalgia describe their daily experience as persistent soreness, similar to what you might feel after an intense workout. This discomfort is often coupled with difficulty concentrating, often described as "brain fog", chronic widespread pain and it can also affect your mood, potentially leading to symptoms of depression or anxiety.

Fibromyalgia is different from a typical injury. It is caused by a process called central sensitization. This is when your central nervous system becomes more sensitive, amplifying pain signals. Even minor stimuli can be perceived as intense and long-lasting pain.

Criteria for diagnosing fibromyalgia

To properly diagnose fibromyalgia, a doctor will assess more than just tender points on your body. The full spectrum of your symptoms is examined. This includes recognizing the deep, widespread pain, along with other symptoms such as severe fatigue, digestive issues, mood disturbances, and cognitive difficulties. These are among the various signs associated with fibromyalgia.

For a definitive fibromyalgia diagnosis, these symptoms must persist for more than three months.

What is GERD?

When that spicy dinner or a bit too much indulgence results in a fiery sensation climbing up your chest, you're likely facing heartburn or acid reflux. However, if this happens over and over again – more than once a week – you might have gastroesophageal reflux disease (GERD).

The symptoms of GERD are caused by the backward (well, upward!) flow of stomach acid into the esophagus – the tube that connects your mouth to your stomach. This frequent backwash can irritate the lining of your esophagus, leading to symptoms that range from mild discomfort to potentially serious inflammation¹.

Diagnosing GERD

Physicians typically diagnose GERD by evaluating your reported symptoms and through physical examinations. To confirm the diagnosis or to determine the existence of any complications, several tests may be employed:

• Upper endoscopy: An endoscope, which is a flexible tube with a camera, is used to inspect your esophagus and stomach for signs of damage or other concerns.
• pH monitoring test: This involves placing a device in your esophagus to measure acid levels and track reflux activity over a period of time.
• Barium swallow X-ray: After swallowing a barium solution, X-ray images are taken to visualize your upper digestive tract.
• Esophageal manometry: This procedure measures the rhythmic muscle contractions of your esophagus when you swallow.
• Transnasal esophagoscopy: A thin, flexible scope is inserted through the nose to provide a view of the esophagus without the need for sedation.

What is the link between fibromyalgia syndrome & GERD?

Research has revealed a mutual relationship between fibromyalgia and GERD, suggesting that the presence of one may increase the likelihood of developing the other. Data from Taiwan’s National Health Insurance found that 40 to 70% of individuals with fibromyalgia also report symptoms of GERD².

Not only does GERD occur alongside fibromyalgia, but it may also intensify the symptoms of fibromyalgia. Academic studies from Fu Jen Catholic University, have also suggested that a genetic component in fibromyalgia could contribute to the development of GERD³.

Irritable bowel syndrome (IBS) & its role in fibromyalgia & GERD

Many people with fibromyalgia experience a variety of digestive issues beyond the common IBS symptoms of bloating and discomfort. These can include nausea, vomiting, and excessive burping. Research suggests that around half of those with fibromyalgia also experience IBS, particularly those with mixed bowel habits or constipation.

Heartburn alongside IBS symptoms might indicate co-existing gastroesophageal reflux disease in some people with fibromyalgia⁴. This overlap highlights the complex connection between these conditions, making it challenging to develop targeted treatment plans for fibromyalgia-related digestive issues.

How to manage fibromyalgia & GERD

Managing both fibromyalgia and GERD can be a complex task, yet with a well-rounded management approach, one can significantly improve their quality of life. Such an approach includes a combination of:

• treatments involving medication
• support through education
• routine physical activities
• psychological therapy
• addressing concurrent conditions like IBS.

Medications to treat GERD or fibromyalgia

To address GERD symptoms that accompany fibromyalgia, you may consider various medications including:

• proton pump inhibitors (PPIs)
• antacids
• medications that reduce acid secretion
• prokinetic agents.

It is crucial to consult your doctor before initiating any of these treatments, as they could interact with the medications you are currently taking.

For managing fibromyalgia, medication is just one component of a comprehensive approach to pain relief. This approach should also include educational, lifestyle, and psychological strategies.

Common medication options for fibromyalgia include:

• over-the-counter pain relievers such as acetaminophen and naproxen
• muscle relaxants like cyclobenzaprine
• antidepressants such as sertraline and fluoxetine
• specialized pain relief medications, for instance, Low Dose Naltrexone (LDN)
• anticonvulsants, which may also help relieve nerve pain, such as topiramate and carbamazepine.

Always discuss these options with your healthcare provider to tailor a treatment plan that best suits your needs.

Physical therapy & exercise

Consider incorporating regular exercise and physical therapy into your fibromyalgia management plan. Low-impact aerobics and strength training can significantly reduce pain and improve your mood. Exercise can enhance your energy levels and alleviate some of the chronic discomfort you experience.

The key to a successful exercise routine is to begin with light, enjoyable activities and gradually increase the intensity. A physical therapist can be a valuable guide. They can create a safe exercise program for you, educate you about fibromyalgia, demonstrate helpful techniques, and recommend home exercises like swimming or gentle yoga.

Remember, balance is crucial. While staying active is important, it's equally important to listen to your body and avoid exceeding its limits.

Retraining your pain

Understanding and retraining the brain's perception of pain is a complex but essential task. It requires identifying the root causes of discomfort, including stress and habitual thought patterns. Recognizing these elements allows for the application of neuroplasticity techniques, aimed at altering the brain's reaction to pain. Consistently practicing these techniques is key to rewiring the neural pathways that interpret pain.

Managing stress

Stress management is very important. Stress can worsen your sensitivity to pain. There are many ways to manage stress effectively. Techniques such as CBT, or cognitive behavioral therapy, can help you develop healthier thought patterns. Mindfulness practices can also help you focus on the present moment and promote calmness. Sharing your experiences with others, through friends, therapy, or support groups, can provide emotional comfort and a sense of community.

Sleep quality

Restful sleep is a cornerstone of effectively managing fibromyalgia. Many people with fibromyalgia experience sleep disturbances, hindering their overall wellbeing. Here are some strategies to improve your sleep quality:

• Prioritize sleep: Aim for eight hours of consistent, nightly sleep.
• Limit naps: Short daytime naps can be helpful, but avoid excessive napping that disrupts nighttime sleep.
• Exercise regularly: Physical activity promotes healthy fatigue, preparing your body for sleep.
• Power down before bed: Disconnect from electronic devices to allow your mind to relax.
• Optimize your sleep environment: Ensure your bedroom is dark, quiet, and cool.
• Minimize stimulants: Limit caffeine intake, especially in the afternoon and evening.
• Avoid disruptive substances: Refrain from large meals and alcohol before bed.
• Embrace relaxation: Engage in calming activities before sleep to promote better rest and manage fibromyalgia symptoms.

More information

At MoreGoodDays®, we offer a comprehensive plan to guide you through the complexities of living with fibromyalgia. We understand the profound effects this condition can have on your daily life, and we are committed to providing you with accessible resources and effective strategies. Our resources are designed with your needs in mind, offering clarity on fibromyalgia and equipping you with the means to manage pain and fatigue.

It is our mission to support you in leading a healthier and more fulfilling life, despite the challenges of fibromyalgia.

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