Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study

Abstract

AIMTo find the association between asthma and different types of functional abdominal pain disorders (FAPDs) among teenagers.METHODA cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated self-administered questionnaires (Rome III questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTSOf the 1101 children included in the analysis, 157 (14.3%) had asthma and 101 (9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain (FAP) (8.9% vs 3.3% in non-asthmatics), functional dyspepsia (FD) (2.5% vs 0.7%), and abdominal migraine (AM) (3.2% vs 0.4%) were higher in those with asthma (P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome (4.5% vs 3.1%, P = 0.2). Severe abdominal pain (10.8% vs 4.6%), bloating (16.6% vs 9.6%), nausea (6.4% vs 2.9%), and anorexia (24.2% vs 16.2%) were more prevalent among asthmatics (P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life (HRQoL) were lower in those with asthma and FAPDs (P < 0.05, unpaired t-test).CONCLUSIONAsthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.

Allergy-related diseases in childhood and risk for abdominal pain-related functional gastrointestinal disorders at 16 years—a birth cohort study

“…When assessing Rome III-defined abdominal pain at 16y, early childhood asthma did not remain associated to AP-FGIDs, whereas asthma at 12y and 16y did. In accordance, the majority of the previous studies including children [ 16 , 17 , 20 – 25 ] report a high prevalence and/or increased risk for abdominal pain of functional origin [ 20 , 22 ], AP-FGIDs [ 21 , 23 ], and IBS [ 16 , 17 , 25 ] when asthma was present. Most studies, however, were cross-sectional [ 20 – 24 ] and of them only Kumari and Colman [ 21 , 23 ] used the Rome III criteria to define AP-FGIDs (none used the Rome IV criteria).…”

“…In accordance, the majority of the previous studies including children [ 16 , 17 , 20 – 25 ] report a high prevalence and/or increased risk for abdominal pain of functional origin [ 20 , 22 ], AP-FGIDs [ 21 , 23 ], and IBS [ 16 , 17 , 25 ] when asthma was present. Most studies, however, were cross-sectional [ 20 – 24 ] and of them only Kumari and Colman [ 21 , 23 ] used the Rome III criteria to define AP-FGIDs (none used the Rome IV criteria). Kumari et al showed an increased risk for concurrent FD, FAP, and abdominal migraine, but not IBS in asthmatics in a population-based sample of 1101 children in Sri Lanka [ 21 ].…”

“…This might suggest that allergy is more connected to IBS than to the other AP-FGID subtypes. Except for the study by Kumari et al discussed above [ 21 ], we found no additional studies that have addressed this issue in children. Hence, it would be of clinical and potentially mechanistic interest to stratify for different AP-FGID subtypes when assessing associations to allergy-related diseases in future studies.…”

“…Most studies, however, were cross-sectional [ 20 – 24 ] and of them only Kumari and Colman [ 21 , 23 ] used the Rome III criteria to define AP-FGIDs (none used the Rome IV criteria). Kumari et al showed an increased risk for concurrent FD, FAP, and abdominal migraine, but not IBS in asthmatics in a population-based sample of 1101 children in Sri Lanka [ 21 ]. This contrasts with our study where asthma was positively associated with IBS, but not AP-FGIDs in general.…”

Update on the Role of Allergy in Pediatric Functional Abdominal Pain Disorders: A Clinical Perspective

“…FD and functional abdominal pain have been associated with asthma in adolescents [ 58 ]. Likewise, asthma and food allergy, allergic rhinitis, and eczema have been associated with FAPDs in adults [ 59 , 60 , 61 , 62 , 63 , 64 ]. In an extensive primary care study, both FD and IBS were associated with allergic conditions, and the relationship was partially explained by a common association with anxiety and depression [ 63 ].…”