Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 944-951
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.944
Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study
Manori Vijaya Kumari, Niranga Manjuri Devanarayana, Lakmali Amarasiri, Shaman Rajindrajith
Manori Vijaya Kumari, Department of Physiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura 50000, North Central Province, Sri Lanka
Niranga Manjuri Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western Province, Sri Lanka
Lakmali Amarasiri, Clinical Physiologist and Senior Lecturer in Physiology, Faculty of Medicine, University of Colombo, Sri Lanka
Shaman Rajindrajith, Department of Pediatrics, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western Province, Sri Lanka
Author contributions: Kumari MV contributed to designing the study, collected, analyzed, and interpreted the data, and drafted the initial manuscript; Devanarayana NM, Amarasiri L, and Rajindrajith S conceptualized the study, contributed to designing the study, and critically analyzed the final manuscript for important intellectual content. All authors approved the final manuscript.
Institutional review board statement: The Ethics Review Committee of Faculty of Medicine and Allied Sciences of Rajarata University of Sri Lanka has granted the ethical approval for this study.
Informed consent statement: Parental/guardian written informed consent was obtained.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Niranga Manjuri Devanarayana, MBBS, MD, PhD, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western Province, Sri Lanka. niranga@kln.ac.lk
Telephone: +94-777-90093900 Fax: +94-11-2958337
Received: August 13, 2018
Peer-review started: August 13, 2018
First decision: October 5, 2018
Revised: November 10, 2018
Accepted: November 14, 2018
Article in press: November 15, 2018
Published online: December 6, 2018
Abstract
AIM

To find the association between asthma and different types of functional abdominal pain disorders (FAPDs) among teenagers.

METHOD

A 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.

RESULTS

Of 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).

CONCLUSION

Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.

Keywords: Health related quality of life, Functional gastrointestinal disorders, Abdominal pain, Asthma, Children

Core tip: A cross-sectional study was conducted to assess the association between asthma and functional abdominal pain disorders (FAPDs) in teenagers. We observed a strong, independent association between asthma and three types of FAPDs, namely, functional abdominal pain, functional dyspepsia, and abdominal migraine, indicating possibility of common underlying pathophysiology. However, no association was observed with irritable bowel syndrome. Most upper gastrointestinal symptoms were more common among asthmatics than in non-asthmatics, but lower gastrointestinal disorders showed no difference. Health related quality of life was significantly decreased in both asthma and FAPDs, indicating the significant impact of both disorders.