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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Aerophagia in adolescents is associated with exposure to adverse life events and psychological maladjustment(Wiley Blackwell Scientific Publications, 2018) Rajindrajith, S.; Hettige, S.; Gulegoda, I.; Jayawickrama, N.; de Silva, S.C.; Samarakoon, H.K.; de Silva, R.L.; Abeyagunawardena, S.; Devanarayana, N.M.BACKGROUND: Aerophagia is a common childhood functional gastrointestinal disorder. We studied the association between adverse life events (ALEs), psychological maladjustment, somatization, and aerophagia (AP) in adolescents. We also assessed the impact of AP on their health-related quality of life (HRQoL). METHODS: A cross-sectional survey was conducted on 2500 subjects of 13-18 years in 8 randomly selected schools in Sri Lanka. Translated, validated, and self-administered questionnaires were used to collect data. Aerophagia was diagnosed using Rome III criteria. KEY RESULTS: A total of 2453 questionnaires were analyzed (males 1200 [48.9%], mean age 14.8 years, SD 1.6 years). Of them, 371 adolescents had AP (15.1%). Aerophagia was associated with exposure to physical abuse (20.4% vs. 12.7% in controls, P < .0001), emotional abuse (20.3% vs. 8.2% in controls, P < .0001), and other ALEs (22% vs. 10.2% in controls, P < .001). One hundred and ninety (51.2%) adolescents with AP and 775 (37.2%) controls had a personality score above the international cutoff value of 105, indicating psychological maladjustment (odds ratio 1.77, 95% confidence interval 1.42-2.21, P < .0001). Those with AP had higher somatization (16.4 vs. 8.9) and lower overall HRQoL scores (77.0 vs. 85.1, P < .0001). HRQoL scores of adolescents with AP were lower in all domains, namely, physical (80.6 vs. 86.9), emotional (69.1 vs. 80.3), social (83.8 vs. 90.5), and school (72.6 vs. 82.5) functioning (P < .0001).CONCLUSIONS AND INFERENCES: Aerophagia was associated with exposure to ALEs and psychological maladjustment. Affected teenagers suffer from more somatic symptoms and has a poor HRQoLItem Aerophagia among school children: epidemiological patterns and symptom characteristics(Lippincott Williams & Wilkins, 2011) Devanarayana, N.M.; Rajindrajith, S.BACKGROUND: Aerophagia is a functional gastrointestinal disease characterized by repetitive air swallowing, abdominal distension, belching and flatulence. In severe cases, it can lead to pneumoperitonium, volvulus and intestinal perforation. Little is known about the epidemiology and clinical profile of affected children. The main objective of this study was to assess the epidemiology of aerophagia in Sri Lankan children and adolescents. METHODS: This cross sectional survey was conducted in 10–16 years old children in 8 randomly selected schools of 4 randomly selected provinces in Sri Lanka. Data were collected using a self-administered questionnaire Questionnaire on Pediatric Gastrointestinal Symptoms - Rome III version, which is translated into native language and pretested for Sri Lankan children). It was distributed in an examination setting and collected on the same day. Trained research assistants were present during the answering of the questionnaire, for any required clarification. Aerophagia was diagnosed using Rome III criteria. RESULTS: In this study, aerophagia was seen in 163 (7.5%), of the 2163 children evaluated. The prevalence was higher in older children (10.5% in 15-year-olds). No gender difference was observed (boys 8.2% vs. girls 6.8%, p>0.05). Other intestinal-related (abdominal pain, nausea and anorexia) and extraintestinal symptoms (headache, limb pain, sleeping difficulty, photophobia and lightheadedness) were more prevalent among affected children ( p<0.05). Out of 163 children with aerophagia, 18 (11%) had difficulty in sleeping and 31 (19.0%) had missed school because of symptoms. Both entities were significantly commoner among children with aerophagia than in controls ( p<0.05). A higher percentage of affected children were found to be exposed to recent stressful life events when compared to controls ( p=0.01). CONCLUSIONS: This study highlights the high prevalence of aerophagia among Sri Lankan children and adolescents. Other intestinal-related and extraintestinal somatic symptoms are frequently seen in affected children. Furthermore, aerophagia has a significant impact on daily activities, such as sleep and schooling, of 10–20% of affected children. This condition is more commonly seen in children exposed to emotional stressItem Abnormal personality traits in children with aerophagia(Lippincott Williams & Wilkins, 2015) Devanarayana, N.M.; Jayawickrama, N.; Gulegoda, I.C.; Rajindrajith, S.OBJECTIVE: The main objective of this study is to study the personality types in children with aerophagia. METHODS: A cross sectional survey was conducted in 8 randomly selected schools in 4 randomly selected provinces Sri Lanka. From each school, all children aged 13-18 years were selected after obtaining written consent from parents, school administration and provincial education office. Assent was obtained from all children recruited. Date were collected using a self-administered questionnaire administered under examination setting to ensure confidentiality and privacy. Questionnaire contained previously translated and validated Rome III questionnaire for functional gastrointestinal diseases (self-administered form for children above 10 years) and childhood personality assessment questionnaire. Trained research assistants were present during filling the questionnaire to provide assistance and to verify doubts. Aerophagia was defined using the Rome III criteria. Severities of individual symptoms were recorded in 100 mm visual analogue scale. RESULTS: A total of 1069 questionnaires were distributed and all of them were returned and included in analysis [males 508 (47.5%), mean age 15.3 years, SD 1.8 years years]. One hundred and thirty six (12.7%) fulfilled Rome III criteria for aerophagia and 933 children without aerophagia were considered as controls. Nineteen (13.8%) children with aerophagia and 71 (7.6%) controls had personality scores above the international cut-off value (105) for abnormal personality (p = 0.01). Children with aerophagia had significantly higher scores for different personality traits than controls; including hostility and aggression (13.2 vs. 12.2 in controls, p = 0.006), negative self-esteem (11.0 vs. 9.9, p < 0.0001), negative self-adequacy (10.6 vs. 9.6, p = 0.001), emotional unresponsiveness (10.5 vs. 9.6, p < 0.0001), emotional instability (16.9 vs. 15.7, p < 0.001), negative world view (10.9 vs. 10.1, p = 0.02) and total personality score (92.1 vs. 87.7, p = 001). In children with aerophagia, scores obtained for severity of bloating correlated with scores obtained for hostility and aggression (r = 0.22, p = 0.02). CONCLUSIONS: Children with aerophagia has abnormal personality traits and this fact may at least partly responsible for development and perpetuation of symptoms in them.Item Aerophagia in children is associated with emotional ill-treatment.(Lippincott Williams & Wilkins, 2015) Rajindrajith, S.; Silva, R. L.; Devanarayana, N.M.BACKGROUND: Aerophagia is a functional gastrointestinal disease characterized by air swallowing, abdominal distension, excessive flatus and belching. The aetiology of this disorder is not clear. Previous studies have suggested an association between aerophagia and psychological stress. We aimed to assess the association between emotional ill-treatment and aerophagia. METHODS: A cross sectional survey was conducted in 4 provinces of Sri Lanka. Children aged 13-18 years were selected from schools in these provinces. A validated, self-administered questionnaires were used for collect data on functional gastrointestinal disease including aerophagia and emotional ill-treatment. Aerophagia was defined using the Rome III criteria. RESULTS: A total of 1069 questionnaires were included in the final analysis (males 508 [47.5%], mean age 15.3 years, SD 1.8 years). One hundred and thirty six (136) children had aerophagia. Prevalence of aerophagia was significantly higher in children who experienced emotional ill-treatments (43 (23.2%) vs. 160 (17.1%), p < 0.0001). Emotional ill-treatments that were significantly associated with aerophagia include, teasing by others (54.1% vs. 45.0%, p < 0.0001), humiliation (38.2% vs. 20.3%, p < 0.0001), treating inferiorly by others (22.8% vs. 11.1%, p < 0.0001), threatening to abandon (8.8% vs. 2.6%, p < 0.0001), threatening destroy belongings (14.0 vs. 4.5%, p < 0.0001), and forcing to do unwanted deeds (9.6% vs. 3.9, p = 0.003). Parenting factors such as refusal of attending to emotional needs (8.8% vs. 3.0%, p < 0.001), refusal to look at (6.6% vs. 0.7%, p < 0.0001), refusal of hugging (10.5% vs. 5.6%, p = 0.03), and not appreciating achievements (5.9% vs. 2.1%, p < 0.0001) were significantly common among children with aerophagia. CONCLUSIONS: Aerophagia in children is associated with emotional ill-treatments. Attending to child's emotional needs likely reduce the prevalence of aerophagia and its consequences.