A lot of people who come to us for pain mention their gut almost as an afterthought. “Oh, and my stomach has been off for years.” Bloating, constipation, a sensitive stomach they've learned to live with.
It's worth paying attention to. The research shows these two problems show up together far more often than chance would explain. It also shows we're still learning why.
Pain and gut problems often travel together
Fibromyalgia is a good example. A systematic review pooled 14 studies of 1,340 adults with fibromyalgia. About 46% also had irritable bowel syndrome, and about 51% had some kind of functional gut disorder (Erdrich et al., 2020).
The authors are careful about the limits. The studies were small, used different ways of diagnosing IBS, and were about 91% women. But the overlap was consistent enough that they called IBS common in fibromyalgia.
The gut bacteria look different
A 2024 review pulled together 21 studies comparing the gut bacteria of people with chronic pain to people without it (Goudman et al., 2024).
People with chronic pain tended to have less variety in their gut bacteria. They also had lower levels of several bacteria generally linked with a healthy gut, including Faecalibacterium and Roseburia.
What the research doesn't show yet
Here's the honest part. These studies show a link, not a cause. We don't know yet whether gut changes drive pain, pain drives gut changes, or something else drives both. The 2024 review describes the changes as non specific and says the connection between gut bacteria and chronic pain is still not clear.
So be wary of anyone promising that fixing your gut will fix your pain. Nobody can promise that yet.
Why it still matters for your care
If your pain hasn't responded the way it should, it's worth looking past the joint that hurts. In the office, people with gut symptoms often tell us their sleep and energy are off too, and those shape how pain feels day to day.
That's why we ask about digestion even when you come in for your back. When the history points that way, we use functional labs chosen for your symptoms, not a standard panel, to see what's actually going on.
If you've been dealing with pain and gut problems at the same time, book a complimentary 20 minute consultation. We'll listen to the whole story, not just the part that hurts.