Fibromyalgia (FM) is characterized by the presence of multiple symptoms. The severity of symptoms can change depending on stress levels, your activity level, the weather, and other illnesses. There's a link between FM flare-ups and the menstrual cycle. Many women who suffer from FM report an increase in headaches, body pain, memory problems and sleep difficulties, in the period leading up to, and during the first half of their menses.

In an article published in PubMed, researchers concluded,

"The menstrual cycle and the onset of menopause affect pain and the severity of other FM-related symptoms in approximately one half of the subjects."

Ninety percent of FM sufferers also are afflicted with Chronic Fatigue Syndrome. In addition to pain and fatigue, common symptoms include malaise, headaches, numbness and tingling, dizziness, sleep disturbance, swollen feeling in tissues, stiffness, sensitivity to noise and stress, and cognitive impairment.

The following are symptoms and associated disorders of FM.

• Widespread Pain
• Fatigue
• Sleep Disorders
• Restless Leg Syndrome (RLS)
• Chest Pain
• Persistent Headaches
• T.M.J.
• Mitral Valve Prolapse
• I.B.S.
• Vision Problems
• Urinary Problems
• Acid Reflux

 

• Nausea
• Stress
• Sensitivity
• Sensation of Swelling
• Anxiety
• Depression
• Cognitive Impairments
• Weight Gain
• Paresthesia
• Disequilibrium

The pain of Fibromyalgia (FM) has no boundaries. It can go from a deep muscular throbbing pain, to a shooting and stabbing pain, along with a burning sensation - similar to the feeling of a brush burn of the skin.

Quite often the pain and stiffness is worse in the morning. FM pain affects the skeletal muscles, ligaments, and tendons in the body.

Pain can also be felt in the bursa, the sacs that surround your joints providing nutrition and lubrication needed for movement. Most FM sufferers will experience pain in all quadrants of the body.

This symptom can be mild in some people, yet incapacitating for other people. The fatigue has been described as "brain fatigue" in which patients feel drained of all energy.

Many people depict this situation by saying it feels as if their arms and legs are tied to concrete blocks. They also report having a difficult time concentrating - referred to as "fibro fog". One of the most disturbing facts is that this fatigue never seems to get better, even with extended periods of rest and sleep.

Alpha-EEG -

Most FM patients have a sleep disorder called the alpha-EEG anomaly. The alpha-EEG sleep anomaly was first described by Hauri and Hawkins, who used the term alpha-delta sleep to characterize a mixture of alpha and delta waves in a small group of psychiatric patients described as having "a general feeling of chronic somatic malaise and fatigue".

Researchers found that most FM patients could fall asleep without much trouble, however, their deep level (or stage 4 sleep) was constantly interrupted by bursts of wide-awake brain activity. This leaves sufferers feeling tired and drained. An alarming percentage of Fibromyalgia sufferers have Alpha EEG Anomaly.

Sleep Apnea -

Sleep Apnea is a sleep disorder characterized by pauses in breathing during sleep. These episodes, called apneas (literally meaning, "without breath"), last long enough so one or more breaths are missed, and occur repeatedly throughout sleep. Sleep apnea is diagnosed with an overnight sleep test called polysomnogram.

Clinically significant levels of sleep apnea are defined as 5 events of any type or greater per hour of sleep time (from the polysomnogram). There are two distinct forms of sleep apnea: Central and Obstructive. Breathing is interrupted by the lack of effort in Central Sleep Apnea. In Obstructive Sleep Apnea, breathing is interrupted by a physical block to airflow despite effort. In Mixed Sleep Apnea, there is a transition from central to obstructive features during the events themselves.

Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. The definitive diagnosis of sleep apnea is made by polysomnography. 80% of people with FM suffer from sleep apnea.

Obstructive sleep apnea (OSA) is not only much more frequent than Central Sleep Apnea, it is a common condition in many parts of the world. If studied carefully in a sleep lab by polysomnography, approximately 1 in 5 American adults has at least mild OSA. Since the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of the throat, the human airway is composed of walls of soft tissue, which can collapse, it is easy to understand why breathing can be obstructed during sleep - particularly in the obese. Although many individuals experience episodes of obstructive sleep apnea at some point in life, a much smaller percentage of people are afflicted with chronic severe obstructive sleep apnea.

Normal sleep/wakefulness in adults has been given 6 distinct stages, numbered 1-4 and including REM sleep (Stage 5) and Wake. The deeper stages (3-4) are required for the physically restorative effects of sleep and in pre-adolescents are the focus of release for human growth hormone. Stages 2 and REM, which combined are 70% of an average person's total sleep time, are more associated with mental recovery and maintenance. During REM sleep in particular, muscle tone of the throat and neck, as well as the vast majority of all skeletal muscles, is almost completely weakened, allowing the tongue and soft palate/oropharynx to relax, and in the case of sleep apnea, to impede the flow of air to a degree ranging from light snoring to complete collapse. In the cases where airflow is reduced to a degree where blood oxygen levels fall, or the physical exertion to breathe is too great, neurological mechanisms trigger a sudden interruption of sleep, called a neurological arousal. These arousals may or may not result in complete awakening, but can have a significant negative effect on the restorative quality of sleep. In significant cases of obstructive sleep apnea, one consequence is sleep deprivation due to the repetitive disruption and recovery of sleep activity. This sleep interruption in stages 3 and 4 (also collectively called Slow-Wave Sleep), can interfere with normal growth patterns, healing, and immune response, especially in children and young adults.

Common signs and symptoms

(The signs and symptoms that follow apply to both adults and children suffering with sleep apnea)

Additional signs of obstructive sleep apnea include restless sleep, and loud snoring (with periods of silence followed by gasps). Other symptoms are non-specific: morning headaches, trouble concentrating, irritability, forgetfulness, mood or behavior changes, decreased sex drive, increased heart rate, anxiety, depression, increased frequency of urination, bed wetting, esophageal reflux and heavy sweating at night.

The most serious consequence of obstructive sleep apnea is to the heart. In severe and prolonged cases, there are increases in pulmonary pressures that are transmitted to the right side of the heart. This can result in a severe form of congestive heart failure (cor pulmonale).

Bruxism -

Bruxism or teeth grinding, frequently affects people with FM. Bruxism is thought to be a part of a disease that is closely related to FM, called Temporomandibular Joint Disorder (TMJD).

This disorder causes muscle pain in the face, neck, shoulders, and back, and often leads to grinding of the teeth. 75% of people with FM also have TMJD. Bruxism usually occurs when you are sleeping. For some reason, sufferers begin to clench the muscles in their face causing their teeth to grind together.

Often, bruxism occurs during sleep; even during short naps. In a typical case, the canines and incisors are commonly moved against each other laterally, i.e. with a side to side action. This abrades tooth enamel, removing the sharp biting surfaces and flattening the edges of the teeth. Sometimes, there is a tendency to grind the molars together, which can be loud enough to wake a sleeping partner. Some will clench without significant side to side jaw movement. Bruxism is one of the most common sleep disorders.

Thirty to forty million Americans grind their teeth on a nightly basis. Given enough time, dental damage will usually occur. Bruxism is the number one cause of occlusal disease and a significant cause of tooth loss.

Over time, bruxing shortens and blunts the teeth being ground, and may lead to pain in the joint of the jaw, the temporomandibular joint, or headache. Most people are not aware of their bruxism and only five to ten percent will develop symptoms such as jaw pain and headache. Teeth hollowed by previous decay (caries) may collapse; the pressure exerted by bruxism on the teeth is extraordinarily high.

A recently introduced device called the BiteStrip enables at-home overnight testing for Sleep Bruxism and might help diagnose bruxism before damage appears on the teeth. The device is a miniature electromyograph machine that senses jaw muscle activity while the patient sleeps. A dentist can establish the frequency of bruxing, which helps in choosing a treatment plan. Anyone having major occlusal rehabilitation should be aware that bruxism can and does ruin dental work.

Restless Leg Syndrome (RLS)

Many people with FM suffer from Restless Leg Syndrome (RLS) symptoms. RLS causes unpleasant sensations in the lower limbs, so much so that the limbs have to be moved in order to reduce the pain.

RLS occurs mostly at night, between the hours of 10:00 pm and 4:00 am, although it can occur throughout the day in severe cases. It is thought that somewhere between 20% and 40% of FM sufferers also have RLS.

The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them. People use words such as: uncomfortable, antsy, electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants inside the legs, and many others. The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms. Some people have little or no sensation, yet still have a strong urge to move.

Any type of inactivity involving sitting or lying - reading a book, a plane ride, watching TV or a movie, taking a nap - can trigger the sensations and urge to move. This depends on several factors: the severity of the person's RLS, the degree of restfulness, the duration of the inactivity, etc.

About 10 percent of adults in North America and Europe may experience RLS symptoms, according to the National Sleep Foundation, which reports that "lower prevalence has been found in India, Japan and Singapore," indicating that ethnic factors, including diet, may play a role in the prevalence of this syndrome.

Medications for RLS:

The medications most commonly prescribed for restless legs syndrome are dopaminergic agents, benzodiazepines, opioids, and anticonvulsants. For people whose symptoms come and go, medications are taken only when the symptoms are a problem.

The class of drugs known as dopaminergic agents are normally the first choice for RLS. These drugs are approved mainly to treat Parkinson's disease; they alter the activity of dopamine, a chemical that carries messages in the central nervous system. However, ropinorole (brand name Requip®) has also been approved by the Food and Drug Administration for moderate to severe RLS.

Other dopaminergic drugs that may be given, although the Food and Drug Administration has not approved them for use in RLS, include levodopa plus carbidopa (Sinemet®), pergolide (Permax - Taken off the U.S. market March 29, 2007 because of the risk of serious damage to patients' heart valves.), and pramipexole (Mirapex®). Side effects include dizziness, drowsiness, nausea, and vomiting. Augmentation, in which symptoms appear earlier in the day, is a problem with long-term use of these drugs. The solution to this problem is usually switching to another drug.

Benzodiazepines are a widely used group of sedatives, often prescribed for insomnia. They work by depressing the central nervous system. This group includes such drugs as diazepam (Valium), temazepam (Restoril®), and clonazepam (Klonopin®). A common side effect from these sedatives is sleepiness lasting into the next day.

Opioids such as codeine and oxycodone (OxyContin®) may also be given for RLS. These drugs relieve pain and cause relaxation. Side effects include nausea, dizziness, and constipation. If these drugs are used long term, addiction can be problem.

Some doctors may recommend anticonvulsants such as carbamazepine (Tegretol®) or gabapentin (Neurontin®) to ease the creepy-crawly feelings of RLS. Side effects include dizziness and drowsiness.

If you have FM you may have noticed that you often feel intense pain in your ribcage and chest. This aching and stabbing pain is very common in FM and can really impact on your enjoyment of life. If your chest pains are making it difficult for you to complete your work, get a good night's sleep, or even breathe deeply, it is important to visit with your health care provider.

Chest pain in Fibromyalgia is usually nothing to worry about, but occasionally it can indicate other problems. The chest pain associated with FM is referred to as costochondritis. Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint - where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

Costochondritis is the most common cause of chest pain originating in the chest wall. It occurs most often in women and people over age 40. However, costochondritis can affect anyone, including infants and children. About 50-80% of FM patients are affected by Costochondritis.

Your doctor might refer to costochondritis by other names, including chest wall pain, costosternal syndrome and costosternal chondrodynia. When the pain of costochondritis is accompanied by swelling it's referred to as Tietze's syndrome.

Most cases of costochondritis have no apparent cause, and most go away on their own. This makes it difficult to treat. When there's no obvious cause, treatment is aimed at easing your pain while you wait for costochondritis to resolve on its own.

Costochondritis causes pain and tenderness in the places where your ribs attach to your breastbone (costosternal joints). Often the pain is sharp, though it can also feel like a dull, gnawing pain. Pain associated with costochondritis occurs most often on the left side of your breastbone, though it can occur on either side of your chest.

Other signs and symptoms of costochondritis may include:

• Pain when taking deep breaths
• Pain when coughing
• Difficulty breathing

Doctors don't know what causes most cases of costochondritis. Only some cases of costochondritis have a clear cause. Those causes include:

• Injury. A blow to the chest could cause costochondritis.


• Infection. Infection can develop in the costosternal joint, causing pain.


• Fibromyalgia. Recurring costochondritis could be a symptom of fibromyalgia. People with fibromyalgia often have several tender spots. The upper part of the breastbone is a common tender spot.


• Pain from other areas of your body. Pain signals can sometimes be misinterpreted by your brain, causing pain in places far away from where the problem occurs. Your doctor might refer to this as "referred pain." Pain in your chest can sometimes be caused by problems with the bones in your spine compressing the nerves.

Costochondritis pain is often mistaken for heart attack pain. The pain of a heart attack is often more widespread, while costochondritis pain is focused on a small area. Heart attack pain usually feels as though it's coming from under your breastbone, while costochondritis pain seems to come from the breastbone itself. Heart attack pain may worsen with physical activity or stress, while the pain of costochondritis remains constant.

Don't waste time, though, trying to distinguish between the two if you're experiencing unexplained and persistent chest pain. Chest pain is an emergency - seek medical attention right away.

Many causes of headache have been described in the medical literature over the years. In 1988, the International Headache Society published a long, detailed classification of headache, which has proved helpful for research purposes because it has led to more reproducible and reliable studies in the field of headache. This classification was recently revised and updated. For practical clinical purposes, however, all headaches can be classified as one of the primary headache syndromes or as a headache that is caused by or secondary to an underlying disease process or condition. Up to 70% of people with FM tend to suffer from the following types of headaches.

Muscle Tension Headaches -

Tension-type headache is characterized by generalized pressure or a sensation of tightness in the head. (FM patients have 6 tender points in this location) The discomfort level is usually mild to moderate and does not worsen with activity. Although nausea and photophobia or phonophobia may occur, they generally are not prominent features. Tension-type headache can be episodic (less than 15 days a month) or chronic (more than 15 days a month).

Some patients with tension-type headache will exhibit evidence of increased muscle tension with prominent scalp tenderness, muscle tenderness in the temporomandibular joint muscles, and/or tight, tender cervical and trapezius muscles. Poor posture is often evident, which may play a role in causing tension-type headache. If no evidence of increased pericranial or cervical muscle tightness (no tenderness or limitation of motion in the neck) is seen during clinical examination, this suggests that the pain originates centrally.

Migraine Headaches -

Migraine headaches are caused by constrictions of your blood vessels and arteries, and are thus also known as vascular headaches. Due to stress, fatigue, or illness, the blood vessels in your head and neck begin to constrict and then dilate, causing severe pain, nausea, dizziness, and eye pain. A migraine headache can also move around your head, shifting from side to side.

The common migraine is usually preceded by episodes of anxiety, depression, and fatigue. The less common type of migraine is the "classic" migraine, and is always immediately preceded by visual symptoms including double vision, blurry vision, flashing dots, bright lights, or distorted vision.

These visual symptoms are often called the migraine aura. Sufferers of the "classic" migraine may experience these symptoms for 15 to 60 minutes immediately before a migraine. Migraine symptoms typically last about 4 hours, though they can plague you for as long as a week. Migraines can develop also into chronic headaches.

There are a number of similarities between migraine and FM. Both diseases appear to involve an exquisite sensitization to stimuli, both are pain syndromes, and depression and anxiety are common in both. Although migraine is chiefly thought of as headache, recent reports indicate that increased sensitization in the periphery is common as well - almost half of migraine sufferers suffer from allodynia (a painful response to normal stimuli) and about 40% display widespread tender points. A recent study found that about 15% of migraine sufferers fit the criteria for FM.

This study found that almost half of FM patients suffered from migraine and 80% suffered from severe headaches. Most intriguingly a finding that headache preceded FM symptoms in almost half of the FM patients suggests that sensitization began in the brain and later spread to periphery. Other studies have found an increased incidence of another pain disease possibly allied with FM, irritable bowel syndrome (IBS), in migraine patients.

Cluster Headaches -

Cluster headache causes intense pain that is generally steady and boring behind one eye. The pain may spread to the temple, face, and even back into the upper neck. It is so intense that most sufferers will pace the floor or do vigorous exercises during the attack. The attacks are short (usually less than 3 hours in duration) and often last only 30 to 45 minutes.

They occur from one to several times a day for a period of several weeks or months, then remit, leaving the patient pain free for several months or years, only to recur. During a cluster headache cycle, the attacks of pain often occur at the same time each day, most often waking the patient in the early morning hours. Eighty percent of cluster sufferers experience unilateral tearing, with conjunctival injection and ipsilateral nasal congestion. Alcohol will bring on an attack within a few minutes in a patient who is in a cluster headache cycle, but it will not induce an attack when the patient is in remission.

Chronic Daily Headache -

Daily headache may occur as a chronic tension-type headache, but is often a combination of tension-type and migraine (as often seen in headache clinics). This type of combination headache does not appear in the current IHS (International Headache Society) classification, but will be added in the revised version to be published in 2003 or 2004. Most often, this type of combination or "mixed" headache occurs in an individual who initially had typical episodic migraine but in whom develops, over several years time, a chronic daily or almost daily headache.

Migraine attacks will occur in addition to the daily headache. Many times, this daily headache seems to develop because of the frequent use of analgesics, especially those combined with caffeine and/or butalbital. A daily or near-daily migraine headache may occur from the frequent use of ergotamine tartrate or any of the triptan drugs. This headache pattern has been called rebound headache or medication overuse headache.

Secondary Headaches -

Secondary headache may be caused by many different diseases. However, neurological symptoms and signs are almost always present before there is significant headache in patients who have a mass lesion in the brain.

Temporal arteritis generally occurs in persons older than 50 years and may be associated with any type of headache. Pain usually is not throbbing and, although it is usually situated in the temples, can be non localized. Fatigue and a low-grade fever are often present. The erythrocyte sedimentation rate is high-usually above 60. Diagnosis is confirmed by a temporal artery biopsy, which typically shows giant cell inflammation. Treatment should begin with 60 mg to 80 mg of prednisone per day as soon as the diagnosis is suspected, even before the confirmation by biopsy. A recent study suggests that methotrexate may be effective in allowing treatment with a lower dose of steroids.6 If not treated, 20% to 30% of patients with this disease will have partial or complete visual loss in the affected eye. Therefore, prompt treatment is essential.

Aneurysms do not cause recurring headache unless compressing a cranial nerve. They present with a severe pain at the time of rupture. Occasionally, an arteriovenous malformation will mimic migraine, particularly if located in the occipital lobe, but these lesions are more apt to cause seizures or bleed. Headaches with a postural component need to be evaluated to exclude a lesion in the posterior fossa. Currently, an MRI scan is the best tool to evaluate the posterior area of the brain. Pericranial inflammation such as sinus infection, ear infection, or dental disease is evident on examination and usually of a more recent, acute onset. Systemic conditions such as endocrine disorders, anemia, sepsis, and hypertension can present as a non localized headache, but more often will exacerbate an underlying migraine or tension-type headache.

Temporomandibular Joint Dysfunction, commonly referred to as TMD or TMJ, is a musculoskeletal disorder that is associated with pain from the neck to the head. The TM joint itself is located just in front of your ear. By placing your first finger on that spot you can feel its movement when you open and close your jaw. TMD occurs when these joints and/or the muscles and ligaments that support them are injured, causing dysfunction and pain. The degree of pain and suffering may range from intermittent and tolerable to chronic, excruciating and totally disabling.

Generally, the definitive diagnosis is made by a dentist after ruling out other possible causes like arthritis, infection, tumors or other infrequent possibilities. Surprisingly, the root cause of this problem often stems from trauma, a physical injury to that area of the body. The trauma can be a direct blow to the head or face, an indirect blow like a whiplash injury, or a micro trauma such as clenching or grinding the teeth repeatedly when under emotional stress. Sometimes the pain may not start for several months or even years after the initial injury. Other times it may be a succession of individual traumas, until one finally initiates the dysfunction and pain. TMD can be the source of complaints of headaches, earaches, facial pain, jaw clicking and popping, locked jaw, neck and shoulder pain, or even dizziness. The trauma leads to injury or spasms in the muscles used for chewing food and the neck muscles, and possibly additional injury to the tissues within the joints.

There are several ways in which psychological factors may play a role in TMD. Sometimes when people are under too much stress, they clench or grind their teeth together, or tense their muscles, knowingly or unknowingly, and cause injuries to themselves. Other times, muscle tension caused by emotional stress, prevents a physically injured area from healing which results in continuing pain. Still other times, people who have had repeated treatment failures cannot trust their doctors and don't cooperate with the treatment plan. This prevents themselves from getting proper help. Whatever the cause of the pain, having pain causes changes in one's behavior, feelings and thoughts. It can damage every aspect of one's life.

When the suffering is so great as to cause disability, it is best to work with a team of professionals who will work with you to regain full functioning. A team may include a dentist, psychologist, physical therapist, neurologist and other specialists.

One of the simplest and most common procedures for treating some of the psychological aspects of this disorder is stress management. While the entire topic is too broad for this article, specific techniques for TMD have been developed and can be tried by anyone. Stress management may prove useful to you if you have found any of the following true:

• pain that gets worse with stress or tension
• certain people or situations make the pain worse
• work or family pressures are made more difficult because of the pain
• you find that the pain frequently makes you irritable
• you feel nearly out of control, with no idea how to cope with the pain
• others perceive you as being "stressed out"

Mitral valve prolapse is a common heart disorder. It occurs when the valve between your heart's left upper chamber (left atrium) and the left lower chamber (left ventricle) doesn't close properly. When the left ventricle contracts, the valve's leaflets bulge (prolapse) upward or back into the atrium. Mitral valve prolapse sometimes leads to blood leaking backward into the left atrium, a condition called mitral valve regurgitation.

Mitral valve prolapse affects slightly more than 2 percent of adults in the United States. Men and women appear to develop MVP in similar numbers. In most people, mitral valve prolapse is harmless and doesn't require treatment or changes in lifestyle. It also doesn't shorten your life expectancy. In some people with mitral valve prolapse, however, the progression of the disease requires treatment.

Although mitral valve prolapse is a lifelong disorder, many people with this condition never have symptoms. When diagnosed, people may be surprised to learn that they have a heart abnormality. When signs and symptoms do occur with mitral valve prolapse, it's typically because blood is leaking backward through the valve (regurgitation). Symptoms can vary widely from one person to another. They tend to be mild, develop gradually and may include:

• A racing or irregular heartbeat (arrhythmia)
• Dizziness, lightheadedness
• Fatigue
• Chest pain that's not associated with a heart attack or coronary artery disease
• Difficulty breathing or shortness of breath, often when lying flat or during physical, exertion

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

As many as 20 percent of the adult population, or one in five Americans, (4-70% of FM patients), have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.

Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms can vary from person to person. Some people have constipation, which means hard, difficult-to-pass, or infrequent bowel movements. Often these people report straining and cramping when trying to have a bowel movement but cannot eliminate any stool, or they are able to eliminate only a small amount. If they are able to have a bowel movement, there may be mucus in it, which is a fluid that moistens and protect passages in the digestive system. Some people with IBS experience diarrhea, which is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent and uncontrollable need to have a bowel movement. Other people with IBS alternate between constipation and diarrhea. Sometimes people find that their symptoms subside for a few months and then return, while others report a constant worsening of symptoms over time.

Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon (large bowel) that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved.

• Normal motility, or movement, may not be present in a colon of a person who has IBS. It can be spasmodic or can even stop working temporarily. Spasms are sudden strong muscle contractions that come and go.


• The lining of the colon called the epithelium, which is affected by the immune and nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the epithelium appears to work properly. However, when the contents inside the colon move too quickly, the colon looses its ability to absorb fluids. The result is too much fluid in the stool. In other people, the movement inside the colon is too slow, which causes extra fluid to be absorbed. As a result, a person develops constipation.


• A person's colon may respond strongly to stimuli such as certain foods or stress that would not bother most people.

Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, people with IBS experience problems with bowel movement, motility, and sensation-having more sensitive pain receptors in their GI tract.

Vision problems can often accompany Fibromyalgia (FM). FM leads to changes in eyesight because it impacts the nervous system, which is the center of sensitivity in the body. When a person develops FM, usually harmless objects can produce pain and sensitivity. FM sufferers can for example develop sensitivity to stimuli such as fluorescent lights or to the light produced by a television set.

Contact lenses can cause pain and irritation, while wearing glasses can trigger Myofascial trigger points in the face and the neck. Pain can also be experienced in the ears, teeth and nose. FM can also lead to the production of a thick secretion, which subsequently impacts vision. Night driving can be dangerous for those with FM, as they often have trouble seeing the lights of oncoming cars.

Urinary and pelvic complaints are common symptoms in 70% of FM patients, particularly in women with the disease. Bladder incontinence, urinary frequency, and painful sexual intercourse are just a few of the urinary disorders and pelvic symptoms that FM can cause.

If you have Fibromyalgia and think that your symptoms may indicate a problem with your urinary tract or pelvic area, consult with your doctor. Your pain and discomfort can be minimized, helping you to live a more active and fulfilling life.

Also known as Gastroesophogeal Disease (GERD), this illness occurs in up to 70% of FM patients. GERD is caused when the opening between the esophagus and the stomach becomes looser or relaxes at the wrong times.

Normally, this opening allows food to travel only from your esophagus to your stomach. A muscular valve, called a sphincter, normally keeps stomach contents, including stomach acid, in the stomach. When the sphincter becomes loose, or relaxes at the wrong times, stomach contents can flow up from the stomach into the esophagus. This irritates the lining of the esophagus and over time, this lining is eaten away.

Nausea can arise for a variety of reasons: anxiety, fear, fatigue, or stress. Sometimes nausea can cause vomiting, and sometimes it will pass without any further symptoms. Between 40% and 70% of FM sufferers report symptoms of both chronic nausea and vomiting.

These symptoms can vary in intensity, with many only experiencing mild to moderate nausea. However, some FM patients have to deal with constant nausea that can last for weeks, or even occur on a daily basis. Such intense nausea can really exacerbate the other symptoms of fibromyalgia and prevent sufferers from continuing on with their daily lifestyle.

It is important for such severe nausea to be diagnosed by a health care professional, to prevent further complications and poor quality of life.

If you suffer from FM you should be especially careful about the amount of stress you are experiencing. Stress plays a big role in triggering FM symptoms. Episodes of emotional stress and anxiety can bring on muscle pain and headaches, or even cause anxiety attacks. Even external stressors, such as loud noises or bright lights, can trigger FM symptoms.

No one is really sure why FM sufferers react so badly to stress. It may be because stress can cause our bodies to release certain hormones. These hormones can interfere with pain perception in FM sufferers.

Others believe that stress increases muscle tension and soreness. In order to keep your FM symptoms in check, work to limit the stress in your life. Take regular breaks from work and home life, and reduce your workload. Practice meditation and regular exercise to help deal with excess energy or stressful situations.

Up to 70% of FM patients are effected by sensory sensitivity. Hypersensitivity to light, noise, touch, odors, as well as heat and cold.

Allergic-type symptoms (i.e., rhinitis, itching, rash, etc.) may also occur along with sensitivity to various foods, medications, and weather changes.

60% of FM patients report a sensation of swelling in the feet and hands, without actual swelling present.

Anxiety is very common amongst those who have been diagnosed with FM. It often occurs in the months following diagnosis, and is thought to affect as many as 70% of FM patients.

Anxiety is thought to be the result of chemical changes in the body. Special chemicals found inside of the brain are responsible for governing mood and stress levels. Known as neurotransmitters, these chemicals (like serotonin) help to send messages to different receptors in the brain.

These receptors than change the way we perceive and react to a situation. When levels of these neurotransmitters aren't balanced properly, it can cause the body to experience feelings of anxiety. Researchers aren't sure why FM patients suffer so much from anxiety, but it may have something to do with low levels of serotonin in the brain. Many FM sufferers have low serotonin levels, and this could be responsible for the pain, depression, and anxiety that come along with FM.

FM is a very painful and frustrating illness to have. FM symptoms like chronic headaches, sleep disorders, and muscle aches and pains can make living with the illness difficult and tiresome. Lack of understanding from the medical community, as well as friends & family members, can also make many FM sufferers feel isolated and alone.

As a result, many people with FM experience chronic depression alongside their illness. Depression can leave you feeling alone, anxious, and extremely sad, and can make FM even more troublesome to deal with. It is important to recognize the symptoms of depression so that you can seek appropriate treatment from your health care provider.

You are not alone - help for depression is out there and can include support groups, prescription medications and botanical supplements.

Have you forgotten where you put your keys again? Having trouble remembering what you were supposed to do this afternoon? Do you have difficulty finding the right words to use to express yourself? If you are experiencing some or all of these memory problems you may be suffering from cognitive impairments, also known as "fibro-fog".

Fibro-fog can be one of the most stressful and upsetting FM symptoms. If you know someone with FM or if you are suffering from the illness, keep an eye out for the indicators of fibro-fog. These symptoms tend to descend in a haze or "fog," around the sufferer. Fibro-fogs can occur at any time and can vary in intensity when they do occur.

Fibro-fogs tend to be at their most severe during flare ups in pain. Inability to concentrate, inability to remember, feelings of brain fog, difficult time expressing yourself with words, these are all symptoms of fibro-fog.

FM often causes weight gain in individuals due to a number of factors that are both directly and indirectly related to the disease itself. FM leads to hormonal imbalances, affecting levels of cortisol, thyroid, serotonin and insulin, as well as the production of growth hormones.

Because of this hormonal imbalance, metabolism slows down and weight gain often follows. Fatigue associated with FM also leads to increased weight. Because FM initiates an arousal disturbance in the brain wave pattern during sleep, the individual can't get enough quality sleep; the individual can also suffer from sleep apnea and restless legs, which increase tiredness.

A new study found that a lack of sleep also leads to higher hypocretin production, which is important in sleep and appetite levels. When hypocretin neuron levels are high (due to environmental and mental stressors), they lead to an increased state of arousal, leading not only to fatigue, but also to overeating.

Drugs taken to treat FM-related depression can also cause the individual to gain weight. Antidepressants like Prozac and Zoloft increase appetite, fluid retention, and can affect hormone levels and therefore metabolism.

Paresthesia is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being "asleep". Numbness or tingling, particularly in the hands or feet, sometimes accompanies FM.

FM patients may be troubled by light-headedness and/or balance problems for a variety of reasons. Since FM is thought to affect the skeletal tracking muscles of the eyes, "visual confusion" and nausea may be experienced when driving a car, reading a book, or otherwise tracking objects. Alternatively, weak muscles and/or trigger points in the neck or TMJ dysfunction may cause dizziness or Disequilibrium. Researchers at Johns Hopkins Medical Center have also shown that some FM patients have a condition known as neurally mediated hypotension which causes a drop in blood pressure and heart rate upon standing with resulting light-headedness, nausea, and difficulty thinking clearly.