Browsing by Author "Hathagoda, W."

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Constipation in children: the Sri Lankan perspective
(Sri Lanka Medical Association, 2021) Hathagoda, W.; Rajindrajith, S.; Devanarayana, N.
No Abstract available
Functional diarrhea in children
(All India Institute Of Medical Sciences, 2024) Rajindrajith, S.; Hathagoda, W.; Devanarayana, N.M.
Functional diarrhea in children is a disease that has been focused on by both general pediatricians as well as pediatric gastroenterologists across the world. Although it is seen across the pediatric age group from late infancy to adolescence, most still believe that functional diarrhea only occurs in younger children. Recent epidemiological studies have shown that functional diarrhea is prevalent in all subcontinents. The classic clinical features include chronic loose stools with undigested food particles without growth faltering. Although known for long years, pathophysiological mechanisms and therapeutic options are not well explored, and the existing literature is outdated. In this article, authors review the available literature on functional diarrhea, with a reminder that a fresh look is needed to broaden the horizons of understanding of this disease.
How do we define normal bowel frequency from newborn to teens?:A Bayesian meta-analysis
(Wiley, 2024-12) Munasinghe, S.; Manathunga, S.; Hathagoda, W.; Kuruppu, C.; Ranasinghe, P.; Devanarayana, N. M.; Baaleman, D. F.; Benninga, M. A.; Rajindrajith, S.
OBJECTIVES Defecation disorders are a common pediatric problem and bowel frequency is crucial in identifying them. The aim of this analysis is to define normal bowel frequencies in healthy children ranging from newborns to adolescents. METHODS A literature search was conducted using MEDLINE, SCOPUS, EMBASE, Cochrane Library, and Web of Science from their inception to February 2024, aiming to identify studies reporting bowel habits of healthy children (0–18 years). A Bayesian distribution modeling approach was adopted to pool the mean frequency of bowel opening using inverse-variance weighing. A subgroup analysis and a meta-regression were performed with Bayesian generalized additive mixed distributional models. The methodological quality of the articles was evaluated using the Newcastle–Ottawa Scale modified for cross-sectional studies. RESULTS Seventeen studies were included in the analysis, including 22,698 children aged from 0 to 18 years. The subgroup meta-analysis showed mean bowel frequencies for newborns, 1–6 months, 6–12 months, 1–2 years, 2–5 years, and over 5 years are 3.24 (95% credible interval [CrI]: 2.83–3.63), 1.99 (95% CrI: 1.77-2.19), 1.66 (95% CrI: 1.45–1.88), 1.53 (95% CrI: 1.37–1.7), 1.15 (95% CrI: 0.99–1.31), and 1.02 (95% CrI 0.88–1.18), respectively. Between studies, heterogeneity demonstrated a near-normal distribution with a mean of 0.16 and a 95% CrI of 0.04–0.28. The variance of the distribution of mean bowel frequency reduced with age. DISCUSSION In this Bayesian meta-analysis, we found that younger children have a higher bowel frequency. The reported bowel frequencies for each age group could serve as normal values in clinical practice to differentiate health and disease.
Imaging in pediatric disorders of the gut-brain interactions: current best practice and future directions
(Taylor and Francis Group, 2023) Rajindrajith, S.; Hathagoda, W.; Ganewatte, E.; Devanarayana, N.M.; Thapar, N.; Benninga, M.
INTRODUCTION: Disorders of Gut-Brain Interactions (DGBI) are a common clinical problem in children and pose significant challenges to the attending pediatrician. Radiological investigations are commonly ordered to evaluate these children. AREA COVERED: This review focuses on the current best practice of using radiological investigations in DGBIs and how novel radiological investigations could revolutionize the assessment and therapeutic approach of DGBI in children. EXPERT OPINION: We believe imaging in DGBI is still in its early stages, but it has the potential to revolutionize how we diagnose and treat children with DGBI. As the understanding of the gut-brain axis continues to grow, we can expect to see the disappearance of conventional imaging techniques and the emergence of more sophisticated imaging techniques with less radiation exposure in the future which provide more clinically meaningful information regarding the gut-brain axis and its influence on intestinal function. Some of the novel imaging modalities will be able to broaden our horizon of understanding DGBI in children providing more useful therapeutic options to minimize their suffering.
Maternal perception of adequacy of mother's milk among mothers giving birth at a teaching hospital in Sri Lanka
(Sage Publications, 2019) Rodrigo, R.; Rodrigo, A.; Liyanage, N.; Hathagoda, W.; Hewavitharana, U.
BACKGROUND: Sri Lanka boasts high rates of early and exclusive breastfeeding. Perceived inadequacy of milk, a global problem, is the main cause for early cessation of breastfeeding. Research Aims: The aims of this study are to (a) determine the prevalence, (b) identify the risk factors, and (c) ascertain the association that maternal psychological distress has with perceived inadequacy of milk (PIM), among mothers during the early postpartum period. Identifying and addressing modifiable risk factors for PIM may improve mothers' satisfaction with breastfeeding. METHODS: A cross-sectional descriptive study of mothers ( n = 249) during the first week after birth was conducted at Colombo North Teaching Hospital (Ragama, Sri Lanka) from May 1, 2016, to June 10, 2016. Participants were recruited when the infant was more than 24 hours but less than 7 days old. A self-administered questionnaire, including the six-item Kessler Psychological Distress Scale, was used. RESULTS: The majority of mothers (78%) perceived their milk quantity to be adequate. A family member telling mothers that their milk supply was low had the most significant associations with perceived inadequacy. Other associations were antenatal maternal complications and birth by cesarean section. Kessler scores indicating psychological distressoccurred in 26% of all participating mothers, with a higher mean score in those with PIM. CONCLUSIONS: Sri Lankan family members should be educated further about normal patterns of milk production during the postpartum period. The authors recommend that PIM be included in screening tools for postpartum depression in Sri Lanka.
Profile of paediatric respiratory diseases requiring hospital admission
(Sri Lanka Medical Association, 2012) Subasinghe, V.; Karunasekera, W.; Fernando, A.D.; Lakmini, C.; Weerasooriya, L.; Hathagoda, W.
INTRODUCTION: Respiratory tract disorders cause significant mortality and morbidity in children worldwide. OBJECTIVES: To study the pattern of respiratory diseases and its seasonal variation among children. METHODS: A descriptive study was conducted at University Paediatric Unit, Colombo North Teaching Hospital in 2010 and 2011. All children below 12 years admitted with respiratory tract diseases (ICD-10 classification) were recruited into the study. Data collection forms were filled by medical officers using patient records. RESULTS: Total of 2651 (1370 in 2010; 1281 in 2011) were admitted with respiratory diseases. In respective years, 53% (2010) and 55%(2011) were males. Highest number of admissions was during infancy (27.2%). During consecutive years 2010 and 2011, 43.0% and 45.2% had unspecified lower respiratory tract infections (LRT1); 29.9% and 29.4% had upper respiratory tract infections (URTI); 10.7% and 12.4% had bronchial asthma; 1.8% and 2.2% had pneumonia; 5.9% and 8.9% had bronchiolitis. Stabilization at ETU was needed in 8.5%. Median duration of hospital stay was 3 (range 1-60) days. No follow-up was required in a majority (82.5%). Admissions due to respiratory diseases peaked in June (2010-20.1% and 2011-16.0%) and were mainly due to LRTI-52.0%, URTI-28.4%. Admissions with bronchial asthma were higher during the first half of the year (2010-86.3% and 2011-80.5%). Deaths were 18 (1.3%) in 2010 and 6 (0.5%) in 2011. CONCLUSIONS: Respiratory tract infections peak in June whereas asthma is precipitated in early months of the year. Over one-fourth of patients had URTI and was unnecessarily admitted.
Quality of life and somatic symptoms in children with constipation: a school-based study
(Elsevier-Mosby, 2013) Rajindrajith, S.; Devanarayana, N.M.; Weerasooriya, L.; Hathagoda, W.; Benninga, M.A.
OBJECTIVE: To assess the health related quality of life (HRQoL) and somatization in school children with constipation. STUDY DESIGN: This cross-sectional survey was conducted in children aged 13-18 years, in 4 schools in Gampaha district of Sri Lanka. Data were collected using a pretested, self-administered questionnaire with questions on bowel habits, somatization, and HRQoL.Constipation was diagnosed using Rome III criteria. RESULTS: A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 and SD 1.3 years). One hundred thirty-eight (7.7%) fulfilled Rome criteria for constipation. Children with constipation had lower HRQoL scores for physical (83.6 vs 91.4 in controls, P < .0001), social (85.0 vs 92.7, P = .0001), emotional (73.6 vs 82.7, P =.0001), school functioning (75.0 vs 82.5, P < .0001), and lower overall scores (79.6 vs 88.0, P = .0001). HRQoL scores were lower in those with fecal incontinence and constipation compared with constipation alone (70.0 vs 81.1, P = .004). Patient perceived severity of abdominal pain (r = -0.22, P = .01) and severity of bowel symptoms (r = -0.22, P = .01) showed significant negative correlation with total HRQoL scores. Total somatization score also found to be negatively correlated (r = -0.47, P < .0001) with HRQoL. CONCLUSIONS: Children with constipation have lower HRQoL scores than controls in physical, social, emotional, and school functioning. They also have a wide range of somatic symptoms. These issues need to be addressed during clinical evaluation of children with constipation to understand the impact of the disease on the life of affected children and to provide optimal care.