{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:18:47Z","timestamp":1774383527429,"version":"3.50.1"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>An association has been shown between functional abdominal pain disorders (FAPDs) and asthma. However, the exact reason for this association is obscured. The main objective of this study is to identify the possible underlying pathophysiological mechanisms for the association between FAPDs and asthma using gastric motility and lung function tests.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>This was a cross-sectional comparative study that consisted of four study groups. Twenty-four children (age 7\u201312 years) each were recruited for four study groups; asthma only, FAPDs only, both asthma and FAPDs, and healthy controls. Asthma was diagnosed using the history and bronchodilator reversibility test. The diagnosis of FAPDs was made using Rome IV criteria. All subjects underwent ultrasound assessment of gastric motility and pulmonary function assessment by spirometry, using validated techniques.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>All gastric motility parameters, gastric emptying rate, amplitude of antral contraction, and antral motility index, were significantly impaired in children with FAPDs only, children with asthma only, and children with both asthma &amp; FAPDs, compared to controls (<jats:italic>p<\/jats:italic>&lt;0.05). Pulmonary function parameters indicating airway obstruction (FEV<jats:sub>1<\/jats:sub>\/FVC ratio, peak expiratory flow rate, FEF25-75%) were not impaired in children with FAPDs only compared to controls (<jats:italic>p<\/jats:italic>&gt;0.05), but significantly impaired in children with asthma and children with both disorders. Antral motility index correlated with the FEV<jats:sub>1<\/jats:sub>\/FVC ratio (<jats:italic>r<\/jats:italic>= 0.60,<jats:italic>p<\/jats:italic>= 0.002) and FEF25%-75% (<jats:italic>r<\/jats:italic>= 0.49,<jats:italic>p<\/jats:italic>= 0.01) in children with both asthma and FAPDs.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Gastric motor functions were significantly impaired in children with asthma, children with FAPDs, and children with both disorders. Motility index, measuring overall gastric motor activity, showed a significant positive correlation with lung function parameters that measure airflow limitation. Therefore, these diseases might arise as a result of primary disturbance of smooth muscle activity in the airways and gastrointestinal wall, which could be a possible pathophysiological mechanism for this association between asthma and FAPDs.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0262086","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T18:28:13Z","timestamp":1641320893000},"page":"e0262086","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Gastric motility and pulmonary function in children with functional abdominal pain disorders and asthma: A pathophysiological study"],"prefix":"10.1371","volume":"17","author":[{"given":"Manori Vijaya","family":"Kumari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakmali","family":"Amarasiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaman","family":"Rajindrajith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2988-110X","authenticated-orcid":true,"given":"Niranga Manjuri","family":"Devanarayana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"issue":"5","key":"pone.0262086.ref001","doi-asserted-by":"crossref","first-page":"e0126982","DOI":"10.1371\/journal.pone.0126982","article-title":"Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis","volume":"10","author":"JJ Korterink","year":"2015","journal-title":"PLoS One"},{"key":"pone.0262086.ref002","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/1471-230X-14-150","article-title":"Quality of life and health care consultation in 13 to 18 year olds with abdominal pain predominant functional gastrointestinal diseases","volume":"14","author":"NM Devanarayana","year":"2014","journal-title":"BMC Gastroenterol"},{"issue":"5","key":"pone.0262086.ref003","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.jpeds.2015.07.058","article-title":"Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome","volume":"167","author":"DR Hoekman","year":"2015","journal-title":"J Pediatr"},{"key":"pone.0262086.ref004","article-title":"Functional Disorders: Children and Adolescents.","author":"JS Hyams","year":"2016","journal-title":"Gastroenterology"},{"issue":"6","key":"pone.0262086.ref005","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1136\/thx.2008.106609","article-title":"Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC).","volume":"64","author":"CK Lai","year":"2009","journal-title":"Thorax"},{"issue":"4","key":"pone.0262086.ref006","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/adc.73.4.321","article-title":"Asthma knowledge, attitudes, and quality of life in adolescents","volume":"73","author":"PG Gibson","year":"1995","journal-title":"Arch Dis Child"},{"issue":"1","key":"pone.0262086.ref007","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/0016-5085(91)90584-8","article-title":"Airway responsiveness to inhaled methacholine in patients with irritable bowel syndrome","volume":"100","author":"AM White","year":"1991","journal-title":"Gastroenterology"},{"issue":"15","key":"pone.0262086.ref008","doi-asserted-by":"crossref","first-page":"944","DOI":"10.12998\/wjcc.v6.i15.944","article-title":"Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study","volume":"6","author":"MV Kumari","year":"2018","journal-title":"World J Clin Cases"},{"issue":"10","key":"pone.0262086.ref009","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.dld.2005.05.006","article-title":"Irritable bowel syndrome in young and elderly patients with stable asthma","volume":"37","author":"A Ekici","year":"2005","journal-title":"Dig Liver Dis"},{"issue":"1","key":"pone.0262086.ref010","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/17474124.2020.1821652","article-title":"Functional abdominal pain disorders and asthma: two disorders, but similar pathophysiology?","volume":"15","author":"MV Kumari","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"pone.0262086.ref011","doi-asserted-by":"crossref","first-page":"742710","DOI":"10.1155\/2011\/742710","article-title":"The pivotal role of airway smooth muscle in asthma pathophysiology","volume":"2011","author":"A Ozier","year":"2011","journal-title":"J Allergy"},{"issue":"4","key":"pone.0262086.ref012","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1080\/17474124.2018.1438188","article-title":"Functional abdominal pain disorders in children","volume":"12","author":"S Rajindrajith","year":"2018","journal-title":"Expert Rev Gastroenterol Hepatol"},{"issue":"21","key":"pone.0262086.ref013","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.3748\/wjg.v24.i21.2211","article-title":"Irritable bowel syndrome in children: Current knowledge, challenges and opportunities","volume":"24","author":"NM Devanarayana","year":"2018","journal-title":"World J Gastroenterol"},{"key":"pone.0262086.ref014","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jpeds.2020.02.076","article-title":"Prevalence of Functional Gastrointestinal Disorders in European Infants and Toddlers","volume":"221","author":"NF Steutel","year":"2020","journal-title":"The Journal of pediatrics"},{"key":"pone.0262086.ref015","unstructured":"Guideline. NNIfHE. Asthma: diagnosis, monitoring and chronic asthman management 2017 [cited 2020 12th August]. Available from: https:\/\/www.nice.org.uk\/guidance\/ng80\/resources\/asthma-diagnosis-monitoring-and-chronic-asthma-management-pdf-1837687975621."},{"issue":"9","key":"pone.0262086.ref016","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1046\/j.1440-1746.2000.02251.x","article-title":"Real-time ultrasonographic assessment of antroduodenal motility after ingestion of solid and liquid meals by patients with functional dyspepsia","volume":"15","author":"H Kusunoki","year":"2000","journal-title":"J Gastroenterol Hepatol"},{"issue":"5","key":"pone.0262086.ref017","doi-asserted-by":"crossref","first-page":"459","DOI":"10.7863\/jum.2003.22.5.459","article-title":"Correlation between simultaneous scintigraphic and ultrasonographic measurement of gastric emptying in patients with type 1 diabetes mellitus","volume":"22","author":"G Darwiche","year":"2003","journal-title":"J Ultrasound Med"},{"issue":"5","key":"pone.0262086.ref018","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1365-2982.2011.01871.x","article-title":"Delayed gastric emptying rates and impaired antral motility in children fulfilling Rome III criteria for functional abdominal pain","volume":"24","author":"NM Devanarayana","year":"2012","journal-title":"Neurogastroenterol Motil"},{"issue":"4","key":"pone.0262086.ref019","first-page":"185","article-title":"Airway resistance in irritable bowel syndrome as measured by impulse oscillometry","volume":"25","author":"B Amra","year":"2006","journal-title":"Indian J Gastroenterol"},{"issue":"4","key":"pone.0262086.ref020","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1097\/MPG.0b013e31827f7a3d","article-title":"Ultrasonographic assessment of liquid gastric emptying and antral motility according to the subtypes of irritable bowel syndrome in children","volume":"56","author":"NM Devanarayana","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"pone.0262086.ref021","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/MPG.0000000000001819","article-title":"Randomized Controlled Clinical Trial on Value of Domperidone in Functional Abdominal Pain in Children","volume":"66","author":"A Karunanayake","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"1","key":"pone.0262086.ref022","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3748\/wjg.v25.i1.95","article-title":"Autonomic functions and gastric motility in children with functional abdominal pain disorders","volume":"25","author":"A Karunanayake","year":"2019","journal-title":"World J Gastroenterol"},{"key":"pone.0262086.ref023","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12876-016-0435-2","article-title":"Abdominal migraine in children: association between gastric motility parameters and clinical characteristics","volume":"16","author":"NM Devanarayana","year":"2016","journal-title":"BMC Gastroenterol"},{"issue":"7","key":"pone.0262086.ref024","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1111\/jgh.12205","article-title":"Gastric emptying and antral motility parameters in children with functional dyspepsia: association with symptom severity","volume":"28","author":"NM Devanarayana","year":"2013","journal-title":"J Gastroenterol Hepatol"},{"issue":"3","key":"pone.0262086.ref025","doi-asserted-by":"crossref","first-page":"355","DOI":"10.5056\/jnm.2013.19.3.355","article-title":"Gastric motility following ingestion of a solid meal in a cohort of adult asthmatics","volume":"19","author":"WA Amarasiri","year":"2013","journal-title":"J Neurogastroenterol Motil"},{"issue":"4","key":"pone.0262086.ref026","doi-asserted-by":"crossref","first-page":"e925","DOI":"10.1542\/peds.2009-2382","article-title":"Gastroesophageal reflux and asthma in children: a systematic review","volume":"125","author":"K Thakkar","year":"2010","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0262086.ref027","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1053\/gast.2001.29545","article-title":"Extraesophageal associations of gastroesophageal reflux disease in children without neurologic defects","volume":"121","author":"HB El-Serag","year":"2001","journal-title":"Gastroenterology"},{"issue":"10","key":"pone.0262086.ref028","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/nmo.12181","article-title":"Influence of gastric emptying on gastro-esophageal reflux: a combined pH-impedance study","volume":"25","author":"G Gourcerol","year":"2013","journal-title":"Neurogastroenterol Motil"},{"issue":"1","key":"pone.0262086.ref029","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1053\/rmed.2001.1409","article-title":"Increased prevalence of irritable bowel syndrome in patients with bronchial asthma.","volume":"97","author":"A Roussos","year":"2003","journal-title":"Respir Med"},{"issue":"9","key":"pone.0262086.ref030","first-page":"652","article-title":"Whole-body plethysmography","volume":"105","author":"CP Criee","year":"2010","journal-title":"Med Klin (Munich)."},{"issue":"2","key":"pone.0262086.ref031","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1067\/mai.2003.1627","article-title":"Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent asthma","volume":"112","author":"A Marotta","year":"2003","journal-title":"J Allergy Clin Immunol"},{"issue":"6","key":"pone.0262086.ref032","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1111\/j.1365-2222.2008.02971.x","article-title":"Pathogenesis of asthma","volume":"38","author":"ST Holgate","year":"2008","journal-title":"Clin Exp Allergy"},{"issue":"1","key":"pone.0262086.ref033","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1136\/gutjnl-2015-309151","article-title":"The role of mast cells in functional GI disorders","volume":"65","author":"MM Wouters","year":"2016","journal-title":"Gut"},{"issue":"4","key":"pone.0262086.ref034","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11894-011-0197-5","article-title":"The role of eosinophils and mast cells in intestinal functional disease","volume":"13","author":"MM Walker","year":"2011","journal-title":"Curr Gastroenterol Rep"},{"issue":"2","key":"pone.0262086.ref035","doi-asserted-by":"crossref","first-page":"181","DOI":"10.5056\/jnm15137","article-title":"Mast Cells and Irritable Bowel Syndrome: From the Bench to the Bedside","volume":"22","author":"L Zhang","year":"2016","journal-title":"J Neurogastroenterol Motil"},{"issue":"7","key":"pone.0262086.ref036","doi-asserted-by":"crossref","DOI":"10.3390\/ijms20071733","article-title":"The Role of Histamine in the Pathophysiology of Asthma and the Clinical Efficacy of Antihistamines in Asthma Therapy","volume":"20","author":"K Yamauchi","year":"2019","journal-title":"Int J Mol Sci."},{"issue":"4","key":"pone.0262086.ref037","first-page":"253","article-title":"Small bowel of patients with asthma and allergic rhinitis: absence of inflammation despite the presence of major cellular components of allergic inflammation","volume":"25","author":"GV Pires","year":"2004","journal-title":"Allergy Asthma Proc"},{"issue":"3","key":"pone.0262086.ref038","doi-asserted-by":"crossref","first-page":"459","DOI":"10.5056\/jnm15174","article-title":"Analysis of Gastric and Duodenal Eosinophils in Children with Abdominal Pain Related Functional Gastrointestinal Disorders According to Rome III Criteria.","volume":"22","author":"EH Lee","year":"2016","journal-title":"J Neurogastroenterol Motil"},{"issue":"5","key":"pone.0262086.ref039","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/BF01295904","article-title":"Reliability and interobserver variability of ultrasonographic measurement of gastric emptying rate","volume":"38","author":"EJ Irvine","year":"1993","journal-title":"Dig Dis Sci"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T09:27:16Z","timestamp":1700040436000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262086"}},"subtitle":[],"editor":[{"given":"Davor","family":"Plavec","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,4]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262086","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,4]]}}}