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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Quality of Life in children with functional constipation: A systematic review and meta-analysis(Elsevier-Mosby, 2019) Vriesman, M.H.; Rajindrajith, S.; Koppen, I.J.N.; van Etten-Jamaludin, F.S.; van Dijk, M.; Devanarayana, N.M.; Tabbers, M.M.; Benninga, M.A.OBJECTIVE:To systematically review the literature on health-related quality of life (HRQoL) in children with functional constipation and to identify disease-related factors associated with HRQoL.STUDY DESIGN:The Pubmed, Embase, and PsycINFO database were searched. Studies were included if they prospectively assessed HRQoL in children with functional constipation according to the Rome criteria. Articles were excluded if patients had organic causes of constipation and if HRQoL was only assessed after successful therapeutic interventions. A meta-analysis was performed calculating sample size-weighted pooled mean and SD of HRQoL scores. The quality of the studies was also assessed.RESULTS:A total of 20 of 2658 studies were included, providing HRQoL data for 2344 children. Quality of evidence was considered to be poor in 9 of the 20 studies (45%); 13 of the 20 studies reported sufficient data to be included in the meta-analysis. Pooled total HRQoL scores of children with functional constipation were found to be lower compared with healthy reference samples (65.6 vs 86.1; P < .01). Similar HRQoL scores were found according to self-report and parent proxy report. Hospital-based studies reported lower HRQoL scores as compared with community-based studies. Two studies reported on HRQoL scores of children with and without fecal incontinence, but no significant difference was found.CONCLUSIONS:HRQoL is compromised in children with functional constipationItem Defecation Disorders in Children: epidemiology and risk factors(Author Publication, 2015) Rajindrajith, S.Item Defecation disorders in children: constipation and functional fecal incontinence(Springer International Publishing, 2016) Rajindrajith, S.; Devanarayana, N.M.; Benninga, M.A.Defecation disorders denote a state of altered defecation dynamics leading to an array of clinical presentations. With the currently available epidemiological studies, it is evident that these disorders have become a set of rapidly spreading global health problems. Due to the broadening of the understanding of escalating health-care costs and poor quality of life, these diseases demand attention of clinicians and researchers, more than at any other time in history. However, it is regrettable that only a little guidance is available for health-care professionals to manage these disorders. Most of the therapeutic trials and investigation plans are archaic from the viewpoint of a twenty-first-century clinician and are not evidence based. However, new research ventures are being carried out, and the horizon of the knowledge base is expanding, perhaps indicating a brighter future. In this chapter, we discuss emerging concepts of definitions, epidemiology, pathophysiology, clinical evaluation, and management of defecation disorders in children and adolescents.Item Bowel habits in Sri Lankan infants and toddlers, a population based study.(Lippincott Williams & Wilkins, 2015) Walter, H.A.; Hovenkamp, A.; Rajindrajith, S.; Devanarayana, N.M.; Benninga, M.A.OBJECTIVE: To obtain knowledge about bowel habits in healthy population of infants and toddlers in Sri Lanka. METHODS: We selected healthy children between 7 months and 5 years of age who visited vaccination and weighing clinics. To achieve data we used a self-administered questionnaire about the child's bowel habits during the previous two months. All subjects were selected in Gampaha district, Sri Lanka. Only those without defecation disorders were used for analysis. RESULTS: A total of 879 toddlers were eligible for analysis, (female n = 442 [50,3%], mean age 21,7 months, standard deviation [SD] 12,5 months). Of them, 595 (69,6%) defecated once a day, 20 (2,3%) had defecation >3/week and 6 (0,7%) <3/week. Stool consistency was hard or very hard in 30 (3,4%), 665 (78,9%) had smooth and soft stool and 107 (12,2%) had varying consistency. Straining and painful stool were reported in 560 (64,7%) respectively 194 (23%) of the sample, stool holding was present in 93 (10,8%) and 44 (4,9%) passed blood with the stool. No children reported fecal incontinence. CONCLUSIONS: This study provides data on normal bowel habits of Sri Lankan toddlers and infants. Bowel habits and disorders related to defecation in Sri Lankan toddlers and children differ from those living in the West probably due to dietary, genetic and environmental variations