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Prevalence of functional GI disorders among pediatric patients with persistent asthma
Ruben J Colman1, Neal Bryan S Rosario2, Analydia Gutierrez Bonilla1
1Department of Pediatrics, SBH Health System, Bronx, New York, USA.
Insights
Functional gastrointestinal disorders (FGIDs) are common in children with asthma, often linked to poor asthma control and anxiety. Early FGID screening in pediatric asthma patients is recommended.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Pulmonology
- Clinical Psychology
Background:
- Functional gastrointestinal disorders (FGIDs) are prevalent in children, causing chronic gastrointestinal symptoms.
- Previous research indicates a significant overlap between FGID and asthma.
- Understanding this comorbidity is crucial for comprehensive pediatric care.
Purpose of the Study:
- To determine the prevalence of FGID in pediatric patients diagnosed with persistent asthma.
- To investigate the association between FGID and asthma control.
- To explore the role of anxiety in FGID among asthmatic children.
Main Methods:
- A prospective, cross-sectional study involving 110 pediatric patients with persistent asthma.
- Utilized the pediatric ROME III questionnaire for FGID assessment.
- Employed the Asthma Control Test and Beck Anxiety Inventory to measure asthma control and anxiety symptoms, respectively.
Main Results:
- 16.4% of pediatric asthma patients met FGID criteria, with functional abdominal pain disorder being most common.
- FGID patients exhibited significantly poorer asthma control (lower scores) and higher anxiety levels.
- While asthma control initially predicted FGID, this association diminished after adjusting for anxiety.
Conclusions:
- Functional gastrointestinal disorders are highly prevalent in children with persistent asthma.
- FGID in pediatric asthma patients is associated with diminished asthma control and elevated anxiety.
- Clinicians should consider FGID screening in pediatric asthma patients with poor control and assess for comorbid anxiety.
Objective:
Functional gastrointestinal (GI) disorders (FGIDs), such as irritable bowel syndrome, functional abdominal pain and dyspepsia, are common causes of chronic GI symptoms in children. Prior studies found high comorbidity of FGID and asthma. This study aimed to assess the prevalence and comorbidities of FGID among pediatric patients with asthma at a university-affiliated urban community hospital.
Methods:
This prospective, cross-sectional study assessed FGID prevalence, asthma control and symptoms of anxiety among pediatric patients with persistent asthma. The pediatric ROME III questionnaire was used to assess FGID. The Asthma Control Test assessed asthma control. The Beck Anxiety Inventory assessed symptoms of anxiety.
Results:
Of the 110 enrolled patients, 18 (16.4%) met the diagnostic criteria for FGID, of which 10 were consistent with the diagnosis of functional abdominal pain disorder. Patients with FGID had a significantly lower mean asthma control score than patients without FGID (11.5 ± 4.9 vs 14.8 ± 5.3, P = 0.03; Cohen's d = 0.6) and higher mean anxiety scores than those without FGID (P < 0.01). Asthma control predicted the presence of FGID (OR 0.90, 95% CI 0.80-0.99, P = 0.03). However, after adjusted for anxiety, asthma control no longer predicted FGID presence (adjusted OR 0.90, 95% CI 0.83-1.05, P = 0.23).
Conclusions:
This study suggests a high prevalence of FGID among patients with persistent asthma. Moreover, patients with FGID had poor asthma control and increased anxiety. Clinicians should consider FGID in patients with poor asthma control and assess them for anxiety.
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