Table 1.
Biliary and fibromyalgia symptoms in basal conditions (1st year-study).
Fig 1.
Pain thresholds in control areas in basal conditions (1st year study).
Means ± SD for all patients’ groups. Significant trend at 1-way ANOVA: P<0.0001 for all parameters (F = 52.251 for EPTs in skin, 45.450 for EPTs in subcutis, 149.21 for EPTs in muscle, 254.60 for PPTs in muscle). The symbols over SD bars denote a significant difference with respect to the other groups.
Fig 2.
Patients [FMS+sGb+Cholec] (n = 31).
Linear correlations between number of previously experienced colics and FMS pain, pain thresholds in TePs, electrical and pressure muscle pain thresholds in control areas in basal conditions.
Fig 3.
Linear correlations between number of previously experienced colics and FMS pain, pain thresholds in TePs, electrical and pressure muscle pain thresholds in control areas in basal conditions.
Fig 4.
VAS scores of abdominal pain during the first week after laparoscopic cholecystectomy (performed on Day0).
Means ± SD. A: 1st year study. B: 2nd year study. Mann-Whitney test for comparison of fibromyalgia groups ([FMS+sGb+Cholec and sGb+Cholec] with the non-fibromyalgia group [sGb+Cholec]). § = significant difference.
Fig 5.
FMS symptoms and pain sensitivity in [FMS+sGb+Cholec].
Patients with fibromyalgia (FMS) plus symptomatic gallbladder calculosis (sGb) subjected to cholecystectomy (cholec) during the first year (n. 31, Means ± SD). (A) Spontaneous fibromyalgia pain (VAS); (B) Pain thresholds to pressure stimulation at the 18 Tender Points (TePs); (C),(D),(E) Pain thresholds to electrical stimulation in skin, subcutis and muscle and to (F) pressure stimulation in muscle in control areas (mean of values recorded in trapezius, deltoid and quadriceps). Basis = pre-operative values; 1w, 1m, 3m, 6m, 12m = 1 week, 1 month, 3 months, 6 months and 12 months after cholecystectomy. ANOVA for repeated measures: significant trend, P<0.0001, for all parameters [F = 104.79 for VAS; F = 58.793 for PPTs in TePs; F = 87.673 for skin EPTs, F = 108.48 for subcutis EPTs; F = 132.79 for muscle EPTs; F = 68.439 for muscle PPTs]. In each graph, asterisks over SD bars denote a significant difference with respect to pre-operative values.
Fig 6.
Patients [FMS+sGb+Cholec] (n. 31).
Linear correlations between peak postoperative pain and change (decrease) in electrical pain thresholds (EPTs) in muscle of control areas at 1 week and 1 month post-cholecystectomy.
Fig 7.
FMS symptoms and pain sensitivity in [FMS+aGb].
Patients with fibromyalgia (FMS) plus asymptomatic gallbladder calculosis (aGb) not subjected to cholecystectomy (n = 28, Means ± SD), followed for a period of 1 year at comparable time points as patients in Fig 5. (A) Spontaneous fibromyalgia pain (VAS); (B) Pain thresholds to pressure stimulation at the 18 Tender Points (TePs); (C),(D),(E) Pain thresholds to electrical stimulation in skin, subcutis and muscle and to (F) pressure stimulation in muscle in control areas (mean of values recorded in trapezius, deltoid and quadriceps). No significant trend for all parameters. ANOVA for repeated measures: for VAS [P = 0.2250; F = 1.409]; for PPTs in TePs [P = 0.8704; F = 0.3670]; for EPTs in skin [P = 0.5311; F = 0.8291]; for EPTs in subcutis [P = 0.2357; F = 1.380]; for EPTs in muscle [P = 0.6849, F = 0.6198], for PPTs in muscle [P = 0.3933, F = 1.046].
Fig 8.
FMS symptoms and pain sensitivity in [FMS].
Patients with fibromyalgia (FMS) without gallbladder calculosis (n = 30, Means ± SD), followed for a period of 1 year at comparable time points as patients in Fig 5. (A) Spontaneous fibromyalgia pain (VAS); (B) Pain thresholds to pressure stimulation at the 18 Tender Points (TePs); (C),(D),(E) Pain thresholds to electrical stimulation in skin, subcutis and muscle and to (F) pressure stimulation in muscle in control areas (mean of values recorded in trapezius, deltoid and quadriceps). No significant trend for all parameters. ANOVA for repeated measures: for VAS [P = 0.1200; F = 1.782], for PPTs in TePs [P = 0.8699; F = 0.3679]; for EPTs in skin [P = 0.1460; F = 1.668], for EPTs in subcutis [P = 0.2237; F = 1.411], for EPTs in muscle [P = 0.1109; F = 1.828], for PPTs in muscle [P = 0.1113; F = 1.826].
Fig 9.
FMS symptoms and pain sensitivity in [FMS+sGb].
Patients with fibromyalgia (FMS) plus symptomatic gallbladder calculosis (sGb) not subjected to cholecystectomy (n = 27, Means ± SD), followed for a period of 1 year at comparable time points as patients in Fig 5. (A) Spontaneous fibromyalgia pain (VAS); (B) Pain thresholds to pressure stimulation at the 18 Tender Points (TePs); (C),(D),(E) Pain thresholds to electrical stimulation in skin, subcutis and muscle and to (F) pressure stimulation in muscle in control areas (mean of values recorded in trapezius, deltoid and quadriceps). ANOVA for repeated measures: for VAS [P<0.0001; F = 6.203]; for PPTs in TePs [P<0.0006, F = 4.797]; for EPTs in skin [P<0.02, F = 3.155], for EPTs in subcutis [P<0.003; F = 3.916]; for EPTs in muscle [P < 0.0001; F = 12.869], for PPTs in muscle [P < 0.0001; F = 7.530].
Fig 10.
FMS symptoms and pain sensitivity in [sGb+Cholec].
Patients with symptomatic gallbladder calculosis (sGb) subjected to cholecystectomy (Cholec) during the 1st year (n = 26, Means ± SD). Evaluations performed at comparable time points as for patients in Fig 5. (A),(B),(C) Pain thresholds to electrical stimulation in skin, subcutis and muscle and to (D) pressure stimulation in muscle in control areas (mean of values recorded in trapezius, deltoid and quadriceps). No trend for variation in any of the recorded parameters. ANOVA for repeated measures: for EPTs in skin [P = 0.1050; F = 1.866], for EPTs in subcutis [P = 0.2035; F = 1.472]; for EPTs in muscle [P = 0.3216; F = 1.182]; for PPTs in muscle [P = 0.3018; F = 1.224].
Table 2.
Comparison among groups at times 1w-12m – 1st year study.
Table 3.
Pain thresholds in control areas.
Comparison among groups at times 1w-12m—1st year study.
Fig 11.
FMS symptoms and pain sensitivity in [FMS+sGb with delayed Cholec].
Patients with fibromyalgia (FMS) plus symptomatic gallbladder calculosis (sGb) subjected to cholecystectomy during the second year of study (delayed cholecystectomy) (n = 20, Means ± SD). ANOVA for repeated measures: for VAS, (P<0.0001; F = 33.608); for PPTs in TePs (P<0.0001; F = 89.276, for EPTs in skin (P<0.0001; F = 25.000), for EPTs in subcutis (P<0.0001; F = 52.969), for EPTs in muscle ((p<0.0001; F = 69.778), for PPTs in muscle (p<0.0001; F = 76.896). The asterisk over SD bars indicates a significant difference with respect to basal values.
Fig 12.
Patients [FMS+sGb with delayed Cholec] (n = 20).
Linear correlation between peak postoperative pain and change (decrease) in electrical pain thresholds at control sites at 1st week.
Fig 13.
FMS symptoms and pain sensitivity in [FMS+sGb without delayed Cholec].
Patients with fibromyalgia (FMS) plus symptomatic gallbladder calculosis (sGb), not subjected to cholecystectomy (n = 7, Means ± SD) for a period of 2 years. Evaluation performed during the 2nd year at comparable time points as patients of Fig 11. No significant trend for all parameters. ANOVA for repeated measures: for VAS, (P = 0.1098; F = 1.984), for PPTs in TePs (P = 0.6121; F = 0.7220, for EPTs in skin (P = 0.4864; F = 0.9122), for EPTs in subcutis (P = 0.5140, F = 0.8681), for EPTs in muscle (P = 0.1644; F = 1.703), for PPTs in muscle (P = 0.5311; F = 0.8414).