Pediatric asthma: functional GI disorders common, tied to poor control

  • Colman RJ & al.
  • J Dig Dis
  • 9 Aug 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • 16% of children with persistent asthma have comorbid functional gastrointestinal disorders (FGIDs; e.g., functional abdominal pain, irritable bowel syndrome, and functional dyspepsia).
  • Comorbid FGIDs are associated with poorer asthma control, a finding that may be mediated by higher anxiety.

Why this matters

  • Children with asthma should be screened and treated for FGIDs.

Study design

  • Cross-sectional cohort of 110 children (age, 4-20 years) with persistent asthma, defined as daily inhaled corticosteroid use.
  • FGIDs were diagnosed by ROME-III criteria.
  • Asthma control was measured by the Asthma Control Test (ACT), with higher scores indicating more control.
  • Anxiety was measured by the Beck Anxiety Index (BAI), with higher scores indicating more anxiety.

Key results

  • Patients with FGIDs had poorer asthma control (mean ACT, 11.5±4.9 standard deviations) vs non-FGID patients (mean ACT, 14.8±5.3; P=.03).
  • Patients with FGIDs had greater anxiety (mean BAI, 34±11) vs non-FGID patients (mean BAI, 14±13; P<.01>
  • The association between FGIDs and poorer asthma control may be mediated by anxiety based on multivariate analysis showing that after adjusting for anxiety, poorer asthma control no longer predicted FGID presence.

Limitations

  • Single-institution study may limit generalizability.

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