Functional abdominal pain disorders and asthma: two disorders, but similar pathophysiology?

ABSTRACT

Introduction

Functional abdominal pain disorders (FAPDs) and asthma are common ailments affecting both children and adults worldwide. Multiple studies have demonstrated an association between these two disorders. However, the exact reason for this observed association is not apparent.

Areas covered

The current review has explored available literature and outlined multiple underlying pathophysiological mechanisms, common to both asthma and FAPDs, as possible reasons for this association.

Expert opinion

Smooth muscle dysfunction, hypersensitivity and hyper-responsiveness, mucosal inflammation, and barrier dysfunction involving gastrointestinal and respiratory tracts are the main underlying pathophysiological mechanisms described for the generation of symptoms in FAPDs and asthma. In addition, alterations in neuroendocrine regulatory functions, immunological dysfunction, and microbial dysbiosis have been described in both disorders. We believe that the pathophysiological processes that were explored in this article would be able to expand the mechanisms of the association. The in-depth knowledge is needed to be converted to therapeutic and preventive strategies to improve the quality of care of children suffering from FAPDs and asthma.

KEYWORDS:

• Abdominal pain
• asthma
• immune dysfunction
• microbial dysbiosis
• pathophysiology

Article highlights

• Both FAPDs and asthma are common disorders in children and adolescents, causing a significant impact on health-related quality of life and healthcare expenditure.

• Multiple studies have demonstrated an association between these disorders.

• Both disorders have potential shared pathophysiological mechanisms such as immune dysfunction, mucosal inflammation, and altered permeability, hypersensitivity and hyper-responsiveness of mucosa and smooth muscles, and altered microbiota.

• In this article, we reviewed the potential risk factors and pathophysiological mechanisms common to both asthma and FAPDs.

Acknowledgments

We acknowledge Dr.B.J.C. Perera, Joint Editor, Sri Lanka Journal of Child Health for language editing of this article and Dr. Anton Fernando for creating the figures.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Italics

Genotypes are given in italics

Additional information

Funding

This paper is not funded.