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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Subject: search.filters.subject.Gastrointestinal Disorders

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    The Prevalence and clinical profile of abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs) in 5-12 year olds in Sri Lanka
    (Japanese Society of Neurogastroenterology and Motility (JSNM), Asian Neurogastroenterology and Motility Association(ANMA), 2017) Karunanayake, A.; Rajindrajith, S.; Devanarayana, N.M.
    INTRODUCTION Abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs) are common among Sri Lankan adolescents and teenagers and it is an important healthcare problem. However, studies are rarely conducted to determine the prevalence and clinical profile of AP-FGIDs in 5-12-year age group. METHODS A cross sectional survey was conducted in four randomly selected schools in Gamapaha district of Sri Lanka. All children aged 5-12 years were recruited after obtaining parental consent. Data was collected using a translated and validated parental questionnaire. AP-FGIDs were diagnosed using Rome III criteria. RESULTS A total of 1000 questionnaires were distributed and 709 (70.9%) returned. Properly filled 653 questionnaires were included in analysis [309 (47.3%) boys. mean age 8.8 years (SD 1.9 years)]. Eighty-two (12.6%) fulfilled criteria for the AP-FGIDs. Prevalence of AP-FGIDs was higher in females than male (7.9% vs. 4.5%, p=0.037, Chi-square test). Thirty-two (4.9%) had FAP, 26 (4.0%) had IBS, 21 (3.2%) had FD and 3 (0.4%) had AM. Prevalence in AP-FGIDs in girls has shown a positive correlation with age (r=0.718, p=0. 045, Pearson correlation). The majority of the children had moderate to very severe pain (83.1%), lasting less than one hour (73.1%). In 24.4%, the duration of abdominal pain was more than one year, which was significantly higher in girls (9.27 vs. 6.03, p=0.021 independent T test). Other symptoms were not significantly different between girls and boys (p<0.05). Epigastric (24.4%) and periumbilical (18.3%) were the commonest sites for abdominal pain. Extra-abdominal pain (56.2%), abdominal fullness (51.2%) and headache (46.3%) were the common associated symptoms. CONCLUSION The AP-GIDs is a common disorder with a prevalence of 12.6% in 5-12 year olds in Sri Lanka. It is more common in girls.
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    Impact of early life events (ELE) and family dynamics for developments of abdominal pain predominate functional gastrointestinal disorders (AP-FGIDs) in 5-12 age group
    (Japanese Society of Neurogastroenterology and Motility (JSNM), Asian Neurogastroenterology and Motility Association(ANMA), 2017) Karunanayake, A.; Rajindrajith, S.; Devanarayana, N.M.
    INTRODUCTION The pathophysiology of AP-FGIDs in children are poorly understood. Animal and human studies have suggested that adverse ELE such as pain or stress can induce long-term changes in the neurons. Apart from the abuse other aspects in early life have not been well investigated. METHODS ELE were evaluated in 182 school children with AP-FGIDs (62.1% girls, mean age 8.5, SD 2.1) and 571 children without AP-FGIDs recruited as controls (51.1% girls, mean age 8.8 SD 1.9 ) using a translated and pretested parental questionnaire. AP- FGIDs were diagnosed by Rome III criteria. RESULTS Compared to controls AP-FGIDs patients were low in birth order (1.7 vs. 1.9 p=0.01). Birth order of the parents, maternal and paternal age of marriage and number of members in the house were not associated with AP-FGIDs (p >0.05, Independent sample T test.). Prenatal complications (14.8% vs. 7.4% p= 0.002) and post-natal complications and receiving PBU care (7.7% vs. 3.1% p=0.008) were significantly higher in AP-FGIDs. Gestational period, mode of delivery, duration of hospital stay, period of exclusive breast feeding and duration of breast feeding were not significantly different (p>0.05). Presence of a family member with abdominal pain lasting more than 2 months and the presence of a family member with chronic pain (other than abdominal pain) in the family is also significantly higher in AP-FGIDs families (p<0.0001, Chi-square test). CONCLUSION ELEs occurring during pre and post-natal periods, which is a vulnerable period for developing neurons may be an important contributory factor for the development of AP-FGIDs. Familial predisposition for development of AP-FGIDs highlight the possible genetic basis for pathogenesis of AP-FGIDs. Breast feeding does not protective against the development of AP-FGIDs.
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    Health related quality of life (HRQOL), family impact and disturbances to child activity in children with abdominal pain predominate functional gastrointestinal disorders(AP-FGIDs); School based, cross sectional study
    (Japanese Society of Neurogastroenterology and Motility (JSNM), Asian Neurogastroenterology and Motility Association(ANMA), 2017) Karunanayake, A.; Devanarayana, N.M.; Rajindrajith, S.
    INTRODUCTION This study assessed the impact of AP-FGIDs on life of 5-12-year olds and their families. METHODS A cross sectional survey was conducted in four randomly selected schools in Gampaha District of Sri Lanka. Data was collected using a translated and validated parental PedsQL TM4.0 Generic Core Scales and PedsQL TM2.0 family impact module. AP-FGIDs were diagnosed using Rome III criteria. RESULTS Eighty two AP-FGIDs children (63.4% girls, mean 9.2years, SD 1.9years) and 571 healthy controls (51.1% girls, mean 8.8years, SD1.9 years) were included in the analysis. Scores obtained for HRQOL were lower in those with AP-FGIDs in all domains (total 81.8 vs. 87.3 in controls, physical 85.3 vs. 91.8, emotional 72.5 vs. 81.8, school 73.7 vs. 80.7, p<0.01), except social functioning (89.7 vs. 92.8, p=0.83). The severity of pain negatively correlated with emotional (r=-0.31) and school (r=-0.359) functioning (p<0.01). The total HRQOL score negatively correlated with the number of healthcare consultations (r=-0.25, p=0.008). Scores obtained for family impact were lower in children with AP-FGIDs in all domains (total 79.0 vs. 86.9, physical 76.6 vs. 86.0, emotional 74.7 vs. 83.7, cognitive 81.6 vs. 88.2, communication 87.9 vs. 92.8, worry 83.1 vs. 90.7, family relationship 76.6 vs. 86.0) (p<0.01), except social (86.6 vs. 89.3) and daily activity (74.6 vs. 75.7) domains (p>0.05). The total score in family impact negatively correlated with scores obtained for pain frequency (r = -0.21) and severity (r = -0.267), anorexia (r= -0.20), school interruption (r = -0.19) and disturbances to daily activities (r= -0.32) and child's hobbies (r = -0.27) (p<0.05). CONCLUSION AP-FGIDs are severe enough to reduce HRQOL in affected children and has a significant impact on the families.