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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Item Functional abdominal pain in children and adolescents: association with impaired gastric motility(Sri Lanka College of Paediatricians, 2009) Devanarayana, N.M.; Dharmawansa, R.; Rajindrajith, S.INTRODUCTION: Chronic abdominal pain is a common paediatric problem affecting nearly 10% of school aged children. The majority of them have functional gastrointestinal diseases including functional abdominal pain (FAP). In them, the exact mechanism of pain remains unclear. Periumbilical pain, characteristic of this condition, appears to be of visceral origin, probably originating in the gastrointestinal tract. Gastrointestinal motility disturbances are reported in children with irritable bowel syndrome and functional dyspepsia, but are not properly studied in those with FAP. OBJECTIVES: To evaluate gastric emptying and antral motility in children and adolescents with FAP, DESIGN, SETTING AND METHOD: Sixty six children with FAP [24 (36.4%) males, 4-14 years, mean 8.2 years, SD 2.7 years] referred to the Gastroenterology Research Laboratory for gastric motility studies and 20 healthy children without evidence of gastrointestinal diseases [8 (40%) males, 4-15 years, mean 8.9 years, SD 2.7 years] were evaluated. FAP was diagnosed using Rome III criteria. None had clinical or laboratory evidence of organic diseases except for one control who was positive for Helicobacter pylori stool antigen test. All subjects underwent ultrasonographic assessment of liquid gastric emptying rate (GE) and antral motility, using a previously reported method. RESULTS: Average gastric emptying rate (42.7% vs. 66.2%), amplitude of antral contractions (60.6% vs. 89%), frequency of contractions per 3 minutes (8.5 vs. 9.3) and antral motility index (5.2 vs. 8.3) were significantly lower in patients with FAP compared to controls (p<0.01). Fasting antral area was higher in patients (1.2 vs. 0.6, p<0.01). The gastric emptying rate had a significant negative correlation with the scores obtained for severity of abdominal pain (r=-0.42, p<0.005). CONCLUSIONS: Gastric emptying rate and antral motility parameters are significantly impaired in patients with functional abdominal pain. Gastric emptying rate had negative correlation with the severity of abdominal pain.Item Prevalence of functional gastrointestinal diseases among a cohort of Sri Lankan school children aged 12 to 16 years(Sri Lanka College of Paediatricians, 2009) Devanarayana, N.M.; Adikari, C.; Pannala, W.; Rajindrajith, S.INTRODUCTION: Even though functional gastrointestinal disorders (FGID). such as irritable bowel syndrome and functional constipation, are common among children and adolescents around the world, little is known regarding their prevalence in developing countries including Sri Lanka. The current symptom based criteria (Rome III criteria) were released in 2006 and are still not widely used fay paediatricians for positive diagnosis of FGID. OBJECTIVES: To assess prevalence of FGID among a group of Sri Lankan adolescents using Rome III criteria. DESIGN, SETTING AND METHOD: This is a cross sectional survey conducted in a randomly selected group of 12-16 year olds in a semi-urban school in Gampaha district. A validated, self-administered questionnaire (developed on Rome III criteria for FGID in children) was distributed after obtaining consent from the school administration and the parents. It was administered in an examination setting, to ensure confidentiality and privacy. The questionnaire was in Sinhala, the first language of the cohort. The questions were simple and easy to understand. Research assistants were present during the whole time with students while they were filling the questionnaires and explanations were given whenever the need arose. FGID were diagnosed using Rome III criteria. RESULTS: A total of 464 questionnaires was distributed and 427 (92%) were included in the analysis [214 (50.1%) males, mean age 14.42 years, SD 1.27 years]. Thirty seven incompletely filled questionnaires were excluded from the analysis. According to Rome III criteria, 123 (28.8%) had at least one FGID. Of them, 58 (13.6%) had abdominal pain related FGID [irritable bowel syndrome 30 (7%), functional dyspepsia 14 (3.3%), functional abdominal pain 12 (2.8%) and abdominal migraine 2 (0.46%). Prevalence of functional constipation was 4.2% (18). Aerophagia was seen in 27 (6.3%), while adolescent rumination syndrome was seen in 17 (3.9%). Nonretentive faecal incontinence [1 (0.23%)] and cyclical vomiting syndrome [2 (0.46%)] were rare in our group of school children. There was no age or sex difference in the prevalence of any of the above FGID (p>0.05). CONCLUSIONS: Functional gastrointestinal disorders are a significant problem in our group of school children, affecting more than a quarter of them. Irritable bowel syndrome is the commonest FGID diagnosed.Item Faecal incontinence in Sri Lankan children and adolescents: an epidemiological survey(Sri Lanka College of Paediatricians, 2009) Rajindrajith, S.; Devanarayana, N.M.INTRODUCTION: Faecal incontinence is seen in 1-4% of children and has a significant impact on their quality of life. Community based studies on this important problem are scare. There is no data regarding prevalence of faecal incontinence from developing countries. OBJECTIVES: To detect the prevalence of faecal incontinence in Sri Lankan school children 10-16 years and factors associated with this condition. DESIGN, SETTING AND METHOD: This was a school based, island-wide, cross sectional survey. A validated, self-administered questionnaire was distributed to randomly selected children, aged 10-16 years, in 5 randomly selected schools, from 3 geographically and socio-economically different provinces in Sri Lanka. The questionnaire was filled under guidance of research assistants. Faecal incontinence was defined as defaecation into places inappropriate to the social context, at least once per month, for a minimum period of 2 months. Constipation was defined using Rome III criteria. RESULTS: A total of 2770 questionnaires was distributed and 2686 (96%) were included in the analysis. Of them 55 (2%) had faecal incontinence [male 43 (78%), mean age 11.96 years, SD 1.59 years]. Forty five (82%) had constipation associated faecal incontinence and 10 (18%) had non-retentive faecal incontinence. The highest prevalence was seen in children aged 10 years (5.4%). A significant negative correlation was observed between age and the prevalence of faecal incontinence (r=-0.893, p<0.01). Faecal incontinence was significantly higher in males (male 3.2%, females 0.9%), those exposed to recent school and family related stressful life events and those from lower social classes (p<0.05). Other symptoms associated with this condition were abdominal pain, nausea and vomiting (p<0.05). CONCLUSIONS: Faecal incontinence was seen in 2% of Sri Lankan children and adolescents aged 10-16 years. The majority had constipation associated faecal incontinence. It was more commonly seen in males, younger age, those from a lower social background and children who were exposed to stressful events.