Is abdominal distress a component of an asthma episode?

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Abdominal distress, also known as abdominal pain, can occur anywhere below the ribs to the pelvis.

The National Cancer Institute defines the abdomen as the part of the body containing the pancreas, stomach, intestines, liver, gallbladder, and other organs.

According to a 2018 cross-sectional study with 1,101 teenagers, researchers found significant links between asthma and the following upper gastrointestinal symptoms:

• abdominal pain
• bloating
• nausea
• loss of appetite

Researchers did this study because of earlier evidence of a link between functional abdominal pain disorders and asthma. These disorders include:

• functional dyspepsia, which is a recurring upset stomach
• irritable bowel syndrome (IBS)
• functional abdominal pain-not otherwise specified
• abdominal migraine, which is when a person experiences regular attacks of moderate to severe stomach pain lasting 2–72 hours

Additionally, a 2019 meta-analysis and review found that adults with asthma are twice as likely to have IBS, and adults with IBS are twice as likely to have asthma.

According to the nonprofit Asthma + Lung UK, children may display different abdominal signs and symptoms when on the verge of an asthma attack. Sometimes these can include:

• straining their stomach muscles as part of their efforts to breathe
• complaining of a tummy ache
• avoiding eating
• saying their ribs ache

However, while abdominal distress is possible during an asthma episode, it is not necessarily a common occurrence during acute asthma episodes.

The reason behind the link is unclear. Some researchers think the connection between asthma and functional abdominal pain disorders relates to the dysfunction of the smooth muscle.

Dysfunction of the autonomic nervous system, which regulates involuntary bodily processes such as breathing and digestion, could trigger the dysfunction of the smooth muscle in both the gastrointestinal and respiratory systems.

Researchers suggest it could relate to dysfunction of the mast cells, a type of white blood cell, and altered TH2 immune response, which plays a critical role in the disease process of allergic conditions, such as asthma and allergic diarrhea.

The Asthma and Allergy Foundation of America categorizes asthma symptoms into green, yellow, and red zones. These zones can help people manage their asthma according to the severity of their symptoms.

Green zone

People experiencing green zone symptoms are not having any breathing problems or difficulties going about their daily activities.

Yellow zone

People experiencing yellow “caution” zone symptoms will notice worsening symptoms that require treatment with quick-relief asthma medications. These symptoms include:

• shortness of breath
• coughing
• chest tightness or pain
• wheezing

Asthma symptoms may wake them up during sleep. Symptoms might also appear after exposure to one of their known asthma triggers, or when they have a cold or respiratory illness.

Red zone

People experiencing red “danger” zone symptoms have quickly worsening asthma, and quick-relief medications are not working. Immediate medical care is needed.

These signs and symptoms include:

• chest tightness or pain
• severe shortness of breath that may cause difficulty walking
• faster or slower than normal breathing
• hard or shallow breathing
• chest retractions, which is when the skin sucks in around the neck, chest plate, or rib bones when inhaling
• deep and rapid rising and falling of ribs or stomach
• expanded chest that does not deflate when they exhale
• hunched shoulders

Cyanosis

Another emergency symptom is cyanosis. It is discoloration of the skin, nails, lips, and tongue. It is a sign of low oxygen.

On darker skin tones, the skin may look grayish or whitish. On lighter skin tones, the skin may look bluish.

If a person’s symptoms do not improve after taking quick-relief medications or symptoms get worse quickly, this is considered a medical emergency. They should seek immediate medical attention.

A person can take quick-relief medications at the first sign of asthma symptoms. It is important for the person to keep their medications nearby at all times in case of an asthma episode.

Quick-relief asthma medications include:

• short-acting medications
• rapid-onset beta2-agonists
• anticholinergic bronchodilators, which relax the muscles of the airways

Treating IBS abdominal distress related to an asthma episode

A person with asthma and IBS can try relaxation techniques to reduce the strain on abdominal muscles. For instance, the International Foundation for Gastrointestinal Disorders suggests:

• Diaphragmatic or abdominal breathing: allow the breath to travel deep into the diaphragm
• Progressive muscle relaxation: tense and relax the body’s muscle groups, starting with the forehead and ending at the feet
• Visualization or positive imagery: imagine being in a calm, peaceful, and relaxing place

People with asthma may sometimes experience abdominal distress during an asthma episode, also known as an asthma attack.

This may be due to the dysfunction of the smooth muscle in the gastrointestinal and respiratory systems occurring at the same time.

A person can treat early symptoms of an asthma episode with quick-relief medications, such as short-acting drugs, rapid-onset beta2-agonists, and anticholinergic bronchodilators.

A person can also try abdominal muscle relaxation techniques to help reduce abdominal distress.