AB1063 Swallowing difficulty in fibromyalgia: real or myth?

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1643
• Main Authors: Umay, E., Gurcay, E., Karaahmet, O., Hasturk, A., Dulgeroglu Erdogdu, D.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Body mass index; Chronic pain; Dysphagia; Endoscopy; Fatigue; Fibromyalgia; Patients; Quality of life; Sleep; Swallowing; Ultrasound
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.2451

BackgroundFibromyalgia Syndrome (FMS) is a chronic disease that the most common disease in medical practice. This syndrome is including some general symptoms such as chronic pain, fatique, tenderness and sleep disturbance, that can be seen in many disorders. Other than these, there are symptoms such as dysphagia, which are reported less frequently but have serious consequences such as aspiration. Studies in literature have been reported that this may not be a real swallowing difficulty and may be a symptom of somatization or may be due to adverse events such as drug side effects.ObjectivesThis study was aimed to reveal the presence of dysphagia with objective diagnostic tests in FMS patients.MethodsThis study was conducted on 165 subjects. Patients (n=83) with FMS regardless of whether the complaint is difficulty swallowing as well as had ages between 18–65 were included in the study. Healthy volunteers (n=82) consisting of hospital staff and relatives of patients and sex, age and body mass index-matched with patients were included as control group.Demographic and disease characteristics were recorded. Fibromyalgia Impact Questionnaire (FIQ)was used to assess severity of disease, functional disability and specific quality of life of patients. Also, the general quality of life of patients was evaluated with Short Form-36 (SF-36). All subject were evaluated with clinical screen test (10-item eating assessment tool=Eat-10) flexible fiberoptic endoscopic evaluation of swallowing (FEES) and electrophysiologic evaluation(EE) as well as ultrasonography (US).The patients were divided into two groups according to the presence of complaints of difficulty in swallowing, which was taken with eat-10 as group 1 (with dysphagia) and group 2 (with normal swallowing). Patients ve healthy volunteers (group 3) were compared in terms of swallowing evaluation methods.ResultsTwenty-one (25.3%) of the 83 patients were defined with dysphagia (group 1) as well as 62 (74.7%) patients with normal swallowing (group 2) according to the eat-10 scale. The groups were similar in terms of demographic characteristics (p>0.05).The mean disease severity of the all patients was between moderate and severe levels as well as there was a mild impact on quality of life. Disease severity and quality of life by using FIQ and SF-36 were significantly worse in patients with dysphagia (group 1) compared with normal swallowing patients (group 2)(p<0.05).None of the subjects had dysphagia with endoscopic evaluation. All subjects could drink 20 ml of water which normal dysphagia limit.Swallowing intervals in patients groups were significantly prolonged compared to healthy volunteers (p<0.05). There was no significant difference between the patient groups in swallowing intervals (p>0.05).Ultrasonographic measurement results in healthy subjects were higher than patient groups (p<0.05). But ultrasonographic values of patients groups were similar (p>0.05).ConclusionsSwallowing functions and structures are affected in patients with FMS, even though there are no symptoms of swallowing difficulty. Hence, while the main symptoms such as pain, fatigue and sleep disturbance are being questioned, a detailed evaluation including swallowing should be performed.Disclosure of InterestNone declared