Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Constipation and functional faecal retention in Sri Lankan school children and adolescents(Wiley Blackwell Scientific Publications, 2008) Rajindrajith, S.; Adikari, C.; Pannala, W.; Devanarayana, N.M.INTRODUCTION: Constipation is a common paediatric problem, but little is known regarding it’s prevalence in Asia. AIMS : To assess prevalence of constipation and functional faecal retention among Sri Lankan school children and adolescents. MATERIALS: This is a cross sectional survey. A validated, self-administered questionnaire was distributed to randomly selected children, aged 10–16 years, in 4 randomly selected schools, in 3 geographically and socioeconomically different Provinces in Sri Lanka. Constipation was defined using Rome III criteria and Paris Consensus on Childhood Constipation Terminology (PACCT). Functional faecal retention was diagnosed using Rome II criteria. RESULTS: A total of 2770 questionnaires were distributed and 2699 (97.4%) were included in the analysis [1368 (50.6%) males, mean age 13.17 years, SD 1.72 years]. According to Rome III criteria and PACCT, 416 (15.4%) and 353 (13.1%) had constipation respectively [the agreement Cohen’s kappa (k) = 0.895, p < 0.0001]. Prevalence of constipation was higher in males than in females according to both PACCT (15.1% vs. 11%, p = 0.002) and Rome III criteria (16.8% vs. 14%, p = 0.047). The majority had family history of constipation (p < 0.0001). Straining, bleeding per rectum, abdominal pain, nausea, vomiting, anorexia and weight loss were significantly higher in the affected children (p < 0.001). Hundred and ten (4.1%) had functional faecal retention, of them 104 (94.5%) also fulfilled Rome III criteria for constipation (k = 0.402, p < 0.0001). CONCLUSIONS: Chronic constipation is a significant problem affecting 13–15% of Sri Lankan school children and adolescents. Constipation is commoner among males. Both Rome III criteria and PACCT are effective in diagnosing childhood constipation in epidemiological studiesItem Bowel habits of Sri Lankan children and adolescents(Wiley Blackwell Scientific Publications, 2008) Rajindrajith, S.; Adikari, C.; Pannala, W.; Devanarayana, N.M.INTRODUCTION: Bowel habits vary greatly around the world, depending on food consumption and genetic factors. Thorough understanding of normal bowel habits is essential for correct diagnosis of defecation disorders which are common in paediatric age group. Main objective of this study was to evaluate normal bowel habits of Sri Lankan school children. METHOD: Normal children aged 10–16 years, without defecation disorders (e.g. diarrhoea, constipation, irritable bowel syndrome and non-retentive faecal soiling), were randomly selected from 5 schools in 4 districts in Sri Lanka. Details regarding their bowel habits of previous two months were collected using a pre-tested, self administered questionnaire. RESULTS: A total of 2273 children were recruited (male 50%, mean age 13.25 years, SD 1.7 years). Of them 1710 (75%) opened bowels once daily, while 153 (6.7%) and 11 (0.5%) had bowel motions less than 3 per week and more than 3 per day respectively. Stool consistency was normal in 1925 (84.6%), hard in 86 (3.7%), and 163 (7%) had changing consistency. Straining was present in 641 (28%), painful defecation in 273 (10.5%) and bleeding in 49 (2%). One hundred and four (4.6%) children reported stool withholding behaviour. Bulky stool was present in 156 (7%), while faecal soiling was seen in 15 (0.6%). Hard stools, bulky stools, faecal soiling and straining were commoner in males, whereas, painful defecation and withholding behaviour were common among females (p < 0.05). CONCLUSION: Hard stools, bulky stools, faecal soiling and straining were commoner in males, whereas, painful defecation and withholding behaviour were common among females (p < 0.05).