Microbiota intestinale e fibromialgia: l'asse microbiota-intestino-cervello che modula il dolore

Gut microbiota and fibromyalgia: how modulating the gut-brain axis can reduce nociplastic pain, neuroinflammation and fibro fog. A clinical update for professionals, based on 11 human studies and a recent systematic review published in Nutrients. 📩 For interviews, consultations and personalized programs you can write to my practice: ✉️ [email protected] 🌐 www.edoardocalderoni.it In this update for clinicians and researchers we review how gut microbiota dysbiosis contributes to fibromyalgia — now classified in the ICD-11 as primary chronic pain of the nociplastic type. We follow the circuit linking reduced SCFAs (butyrate), leaky gut and LPS translocation, low-grade endotoxemia with cytokine release (IL-1β, IL-6, TNF-α), increased blood-brain barrier permeability, microglial activation and the neuroinflammation that lowers the pain threshold (hyperalgesia). We also cover tryptophan diversion by the IDO enzyme and its impact on serotonin, fibro fog and mood. On the practical side we discuss the strategies with clinical evidence: multi-strain probiotics (cognition, emotional symptoms, urinary cortisol, microbiota diversity and pain reduction vs placebo), prebiotic fibers (hs-CRP and mood), the role of the IL-1β variant in probiotic response, rifaximin, and mind-body interventions such as mindfulness. We close with clinical application: HPA-axis regulation, intestinal permeability and work within a multidisciplinary, PNEI-oriented team (physician, psychologist, nutritionist, physiotherapist). ⚠️ Educational content only: it does not replace the advice, diagnosis or treatment of a healthcare professional. 🔔 If you work with fibromyalgia and chronic pain, subscribe and turn on notifications for the next science updates. 📚 Reference study Title: Modulating the Gut Microbiota to Target Neuroinflammation, Cognition and Mood: A Systematic Review of Human Studies with Relevance to Fibromyalgia Authors: Dipalma G, et al. Journal: Nutrients, 2025 DOI: https://doi.org/10.3390/nu17142261 ⏱️ Chapters 0:00 Introduction: fibromyalgia as nociplastic pain 3:04 Dysbiosis, leaky gut and neuroinflammation 6:59 Modulating the microbiota: probiotics, prebiotics, rifaximin 10:39 Mind-body interventions and mindfulness 14:05 Clinical application and the PNEI multidisciplinary team #fibromyalgia #microbiome #gutbrainaxis #chronicpain #neuroinflammation