Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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Author: search.filters.author.Karunanayake, A.Subject: search.filters.subject.Gastrointestinal Diseases

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    Effects of body mass index on gastric motility in children with abdominal pain-predominant functional gastrointestinal disorders
    (The Physiological Society of Sri Lanka, 2015) Karunanayake, A.; Devanarayana, N.M.; Rajindrajith, S.
    INTRODUCTION: Objective of this study was to assess the effects of body mass index (BM1) on gastric motility abnormalities in children with abdominal pain-predominant FGIDs (AP- FGIDs). METHODS: Gastric motility parameters of 100 children with AP-FGIDs (39.0% boys, mean age 8.0 years [SD +or -2.1years] and 50 healthy controls (30% boys, mean age 8.6 years [SD +or -1.9 years]) were assessed by previously validated ultrasound method. AP-FGIDs were diagnosed using Rome III criteria. Fifty four had functional abdominal pain, 23 had irritable bowel syndromes, 9 had functional dyspepsia, 8 had abdominal migraine and 6 had more than one AP-FGID. RESULTS: Patients with AP-FGIDs had significantly lower gastric emptying rate (44.9% vs. 59.5% in controls, p<0.0001), frequency of antral contractions (8-3 vs. 9.4, p<0.000l), amplitude of antral contraction (48.6% vs. 58.1%, p<0.000l) and antral motility index (MI) (4.0 vs. 6.4, p=0.001). Fasting antral size (FA) and antral area at Iminute (AA1) and antral area at I5 minutes (AA15) after ingestion of the liquid test meal were not significantly different. BMI of children with AP-FGIDs and controls were respectively 15.2 and 15.6 (p=0.42). The correlations between BMI and AA1 (r=0.29, p=0.007), AA15 (r=0.32, p=0.003) and MI (r=0.22, p=0.038) in children with AP-FGIDs were significant. Patients with BMI <15Kg/m2 had a lower FA (1.5cm2 vs. 2.1cm2, p=0.03), AA1 (8.9 cm2 vs. 10.7 cm2, p=0.003) and AA15 (4.6 cm2 vs. 5.8 cm2, p= 0.01) than patients with BMI >15Kg/m2. CONCLUSION: BMI has an impact on certain gastric motility parameters in children with AP-FGIDs.
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    Therapeutic effects of domperidone on abdominal pain-predominant functional gastrointestinal disorders in children: randomized, double-blind, placebo-controlled trial
    (The Physiological Society of Sri Lanka, 2015) Karunanayake, A.; Devanarayana, N.M.; Rajindrajith, S.
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    Abdominal pain predominant functional gastrointestinal diseases: association with child abuse, traumatic life events and quality of life
    (Wiley Blackwell Scientific Publications, 2012) Devanarayana, N.M.; Rajindrajith, S.; Karunanayake, A.; Nishanthini, S.; Perera, M.S.; Benninga, M.A.
    BACKGROUND/AIMS: Abdominal pain predominant functional gastrointestinal diseases (AP-FGD) have significant repercussions on affected individuals. Aims of this study were to assess its association with traumatic life events and child abuse, and its impact on quality of life. METHODS: Children aged 13–18 years were randomly selected from 3 schools in Western province of Sri Lanka. A previously validated, self administered questionnaire was used to collect information on gastrointestinal symptoms, traumatic life events, exposure to abuse, healthcare consultation and quality of life (QOL). AP-FGD were diagnosed using Rome III criteria. RESULTS AND DISCUSSION: A total of 1365 children were recruited [males 749 (54.9%), mean age 14.2 years and SD 1.22 years]. AP-FGD were found in 243 (17.8%) children [Irritable bowel syndrome in 70 (5.1%), functional dyspepsia in 11 (0.8%), abdominal migraine in 26 (1.9%) and functional abdominal pain in 146 (10.7%)]. Prevalence of AP-FGDs were significantly higher in those exposed to traumatic life events (37.9% vs. 3.1%, p = 0.03), sexual abuse (35.3% vs. 17.3%, p = 0.01), physical abuse (19.7% vs. 12.6%, p = 0.0003), and emotional abuse (27.4% vs. 16.9%, p < 0.0001). Health care consultation was significantly higher in children exposed to physical abuse (26.4% vs. 0.0%, p = 0.03). QOL scores for physical (85.7 vs. 89.6), emotional (71.7 vs. 79.4), social (85.9 vs. 92.3) and school (74.3 vs. 81.1) function domains were significantly lower in children with AP-FGD who were exposed to emotional abuse (p < 0.05). QOL scores for school function domain was lower in children exposed to physical abuse (77.8 vs. 83.6, p = 0.03). CONCLUSIONS: Traumatic life events and child abuse in any form are significantly associated with higher prevalence of AP-FGD. Children exposed to physical abuse are more likely to seek healthcare for abdominal pain. Children with AP-FGD, exposed to emotional abuse, have significantly poor quality of life in all four domains.
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    Therapeutic effects of domperidone on abdominal pain-predominant functional gastrointestinal disorders: randomized, double-blind, placebo- controlled trial.
    (Lippincott Williams & Wilkins, 2015) Karunanayake, A.; Devanarayana, N.M.; Rajindrajith, S.; de Silva, A.
    INTRODUCTION: The therapeutic effect of domperidone on abdominal pain-predominant functional gastrointestinal diseases (AP-FGIDs) was assessed on children in 5-12 year age group at the Gastroenterology Research Laboratory of Faculty of Medicine, University of Kelaniya, Sri Lanka. METHODS: Children fulfilling Rome III criteria for AP-FGIDs were recruited from the out-patient clinic of the University Paediatric Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka, after obtaining parental consent. They were randomized in to 8 weeks of placebo or Domperidone (Motillium 10 mg, 3 times per day, before meals) groups, using computer generated random numbers. Placebo was a specially prepared dummy tablet without any active ingredients, had the same colour, size, shape and taste of domperidone tablet and were packaged similarly. Primary outcomes defined were cure (abdominal pain less than 25 mm on the visual analogue scale and no impact on daily activities) and improvement (pain relief and sense of improvement recorded on global assessment scale). Secondary outcomes were significant improvement in symptoms, gastric motility, quality of life (QoL) and family impact. Both patients and investigators who assessed primary and secondary outcomes before and after intervention were blind to inventions administered. Symptom severity was recorded on a validated 100 mm visual analogue scale. Translated and validated PedQL Generic Score Scale version 4.0 and Family Impact Module were used. Gastric motility was assessed using a validated ultrasound method. RESULTS: One hundred children were enrolled and 89 completed the trial [Placebo 42 (22 girls), Domperidone 47(33 girls)]. While comparing primary outcomes, domperidone group had significant improvement [37 (78.7%) vs. 25 (59.5%) in placebo group, p = 0.04], while no such difference was observed in cure. When assessing secondary outcomes, domperidone group reported significant reduction in abdominal pain severity (70.84% vs. 48.18% p = 0.03) and improvement in motility index (29.3% vs. 8.6% p = 0.04) after intervention. No such difference was seen in improvement of QoL and family impact (p > 0.05). CONCLUSIONS: Domperidone has a favorable therapeutic effect on improvement AP-FGIDs in children aged 5-12 years. It causes significant reduction in abdominal pain and improvement in motility of the gastric antrum. However, it has no significant effect on improvement of QoL and family impact.
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    Effects of body mass index on gastric motility in children with abdominal pain-predominant functional gastrointestinal disorders.
    (Lippincott Williams & Wilkins, 2015) Karunanayake, A.; Devanarayana, N.M.; Rajindrajith, S.
    INTRODUCTION: There is evidence that overweight children have a higher prevalence of functional gastrointestinal disorders (FGIDs) than normal-weight children. Objective of this study was to assess the effects of body mass index (BMI) on gastric motility abnormalities in children with abdominal pain-predominant FGIDs (AP-FGIDs). METHODS: Gastric motility parameters of 100 children with AP-FGIDs (61(61%) girls, mean age 8.0 years [SD 2.1years] and 50 healthy controls (30 (30%) boys, mean age 8.6 years [SD 1.9 years]) were assessed at the Gastroenterology Research Laboratory of Faculty of Medicine, University of Kelaniya, Sri Lanka, using a previously validated ultrasound method. AP-FGIDs were diagnosed using Rome III criteria. Fifty-four had functional abdominal pain, 23 had irritable bowel syndromes, 9 had functional dyspepsia, 8 had abdominal migraine and 6 had more than one AP-FGID. RESULTS: Patients with AP-FGIDs had significantly lower gastric emptying rate (44.9% vs. 59.5% in controls, p < 0.0001), frequency of antral contractions (8.29 vs. 9.44, p < 0.0001), amplitude of antral contraction (48.6% vs. 58.1%, p < 0.0001) and antral motility index (4.0 vs. 6.4, p = 0.001). Fasting antral size (FA) and antral area at 1minute (AA1) and antral area at 15 minutes (AA15) after ingestion of the liquid test meal were not significantly different. BMI of children with AP-FGIDs and controls were respectively 15.2 and 15.6 (p = 0.42). The correlations between BMI and AA1 (r = 0.29, p = 0.007), AA15 (r = 0.32, p = 0.003) and MI (r = 0.22, p = 0.038) in children with AP-FGIDs were significant. Patients with BMI <15Kg/m2 had a lower FA (1.5cm2 vs. 2.1cm2, p = 0.03), AA1 (8.9 cm2 vs. 10.7 cm2, p = 0.003) and AA15 (4.6 cm2 vs. 5.8 cm2, p = 0.01) than patients with BMI >15Kg/m2. CONCLUSIONS: BMI has an impact on certain gastric motility parameters in children with AP-FGIDs. However, it does not contribute to abnormalities seen in main gastric motility parameters such as gastric emptying.