Shaman Rajindrajith

University of Colombo

Functional diarrhea in children is a disease that has been focused on by both general pediatricians as well as pediatric gastroenterologists across the world. Although it is seen across the pediatric age group from late infancy to adolescence, most still believe that functional diarrhea only occurs in younger children. Recent epidemiological studie...

Many widely held beliefs and assumptions concerning childhood constipation continue to interfere with rational management of childhood constipation. Although many still believe that constipation is not a common disease, about 9.5% of the world’s children suffer from chronic constipation. Most of these children live in non-Western countries. There a...

Objectives: Functional abdominal pain disorders (FAPDs) are common gastrointestinal problems in children, and the pathophysiology is thought to be multifactorial. Adverse early life events (ELE) induce alterations in the central nervous system, perhaps predisposing individuals to develop FAPDs. We aimed to study the potential adverse ELE that are...

Background Lymphangiomas are rare benign malformations of the lymphatics that occur due to blockage of the lymphatic system during fetal development. They commonly occur in the neck and axilla, while involvement of the pericardium is rare. We report herein the case of a 16-month-old Sri Lankan child with a large pericardial cystic lymphangioma pres...

Introduction Chronic constipation is a global public health problem that affects the lives of children and caregivers. A subset of children with constipation do not respond to standard medical management and are considered as having intractable constipation. Management of these children is a challenging problem for practicing pediatric gastroentero...

Constipation in children is a major health issue around the world, with a global prevalence of 9.5%. They present to clinicians with a myriad of clinical signs. The Rome IV symptom-based criteria are used to diagnose functional constipation. Functional constipation is also a huge financial burden for healthcare system and has a detrimental impact o...

Aims Nephrotic Syndrome (NS) is the commonest chronic glomerular disease of childhood. A majority (70–80%) have relapsing disease persisting throughout childhood causing a significant psychosocial impact on both children and their families. Objectives of this study were to assess the quality of life (QOL), personality and psychological maladjustmen...

Background Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal distension, and excessive flatus. We aimed to perform a systematic review and a meta-analysis to assess the epidemiology of aerophagia in children. Methods We conducted a...

Background Functional gastrointestinal disorders (FGIDs) are common early in life. The prevalence of FGIDs varies among countries but is unknown in Vietnam. The aim of this study is to assess the prevalence of FGIDs in healthy Vietnamese infants and young children. Methods This was a cross-sectional, observational study involving healthy infants a...

Key points · We investigated the community prevalence and associations of adolescent obesity in a birth cohort from an urban community in Sri Lanka. · In this cohort of adolescents, central obesity (CO) was more prevalent than general obesity (GO). · GO was associated with lower birth order while CO showed association with higher birth weight. · Af...

Background: There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease (PIBD). Aim: To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform. Methods: Clinical, endoscopic and radiologic data at diagnosis from...

Background: Patients with Hirschsprung disease (HD) are at risk of persistent constipation, fecal incontinence or recurrent enterocolitis after surgical treatment, which in turn may impact physical and psychosocial functioning. Generic health-related quality of life (HRQoL) and disease-specific health-related quality of life are relevant outcome m...

Objective to develop a core outcome set (COS) for clinical studies assessing GERD in children. Study design This COS was developed using a 2-round Delphi technique and adhering to the OMERACT 2.0 recommendations. Healthcare professionals (HCPs) and (parents of) children (age 1-18 years) with a GERD diagnosis (i.e. the presence of bothersome sympto...

Background: An association has been shown between functional abdominal pain disorders (FAPDs) and asthma. However, the exact reason for this association is obscured. The main objective of this study is to identify the possible underlying pathophysiological mechanisms for the association between FAPDs and asthma using gastric motility and lung func...

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 widely spread global health problems. Due to the broadening of the understanding of escalating healthcare costs and poor quality of lif...

Background Several cross-sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. Methods PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search ter...

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To evaluate the efficacy and safety of treatments used for intractable constipation in children. Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Background The prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China. Methods A pr...

INTRODUCTION Nephrotic Syndrome (NS) is the commonest chronic glomerular disease of childhood. A majority (70-80%) have relapsing disease persisting throughout childhood. Any chronic childhood disease causes psychosocial impact and behavioural difficulties that have implications for the mental health, social and personality development of the child...

INTRODUCTION Bladder dysfunction (BD) is a chronic nephro-urological condition, resulted from a multitude of aetiologies including posterior urethral valve (PUV), myelomeningocele (MMC), spina bifida, sacral agenesis and non-neurogenic neurogenic bladder. Any chronic childhood disease could trigger physical, emotional, social dysfunction and could...

Functional fecal incontinence (FI) is a worldwide problem in children and comprises constipation-associated fecal incontinence and nonretentive fecal incontinence. Irrespective of pathophysiology, both disorders impact negatively on the psychological well-being and quality of life of affected children. A thorough clinical history and physical exami...

Objectives To assess behavioral and emotional problems in children and adolescents with functional constipation and their relationship with psychological maladjustment and health-related quality of life (HRQoL). Design A school-based cross-sectional survey conducted in 8 randomly selected schools from 4 randomly selected districts in Sri Lanka. A...

Spondylocostal dysplasia (SCD) is a rare costovertebral malformation characterised by short-trunk short stature. It is a recessively inherited disorder, and commonly identified disease-causing mutations are in DLL3 gene. The reported prevalence is 1 : 200,000 worldwide, and none was reported from Sri Lanka. We report a 7-year-old Sri Lankan girl wi...

Background: Aerophagia is a functional gastrointestinal disorder characterized by repeated air swallowing leading to chronic abdominal distension. Symptoms can be long lasting, lead to frustration, and distress. This study describes prevalence, related factors, and symptomatology of aerophagia, together with its relationship with emotional stress....

Introduction: Functional abdominal pain disorders (FAPDs) and asthma are common ailments affecting both children and adults worldwide. Multiple studies have demonstrated an association between these two disorders. However, the exact reason for this observed association is not apparent. Areas covered: The current review has explored available lit...

Objectives: Functional abdominal pain disorders (FAPDs) and functional defecation disorders (FDDs) are common in children and adolescents, but prevalence rates from the Caribbean are lacking. Therefore, our aim was to determine the prevalence of FAPDs and FDDs in adolescents in Curacao and to assess the influence of psychosocial factors on the pre...

Objective To ensure consistency and reduce outcome measure reporting heterogeneity in clinical trials on pediatric functional abdominal pain disorders (FAPDs), a core outcome set (COS) was developed for pediatric FAPD trials. Study design A mixed-method 2-round Delphi technique was used and key stakeholders, including healthcare professionals (HCP...

Background: Functional abdominal pain disorders (FAPD) have been widely reported as a major group of gastrointestinal disorders across the world. This study describes the prevalence, related factors, symptomatology and its relationship to emotional stress in Indonesian adolescents. Methods: This is a cross-sectional study. Adolescents aged 10 to...

Background: Functional constipation (FC) is a pediatric problem that is seen frequently. However, its prevalence in Asia remains undetermined. In this study we attempted to determine the prevalence, risk factors and therapeutic modalities of FC in infants and toddlers in Sri Lanka. Methods: Children aged 6.5 months to 4 years were selected from...

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 fun...

BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood. AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the p...

AIM To find the association between asthma and different types of functional abdominal pain disorders (FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated self-administered qu...

Background: We aimed to study the epidemiology and risk factors, including exposure to emotional stress, for constipation in Indonesian children and adolescents of 10-17 year age group. Methods: A cross-sectional survey using a validated, self-administered questionnaire was conducted in randomly selected children and adolescents in nine state ju...

Multidrug-resistant P-glycoprotein 3 (MDR3) is a phospholipid translocator encoded by the ABCB4 gene located on chromosome 7. MDR3 mediates the translocation of phosphatidylcholine across the canalicular membrane of the hepatocyte into bile. Severe MDR3 deficiency typically occurs during childhood with progressive cholestasis evolving to cirrhosis...

A human-porcine reassortant rotavirus, strain R1207, was identified from 74 group A rotaviruses detected in 197 (37.6%) stool samples collected from patients who attended a tertiary care hospital in Ragama, Sri Lanka. This is the first report of a human-porcine reassortant rotavirus in Sri Lanka. The patient was a 12-month-old boy who had been hosp...

Irritable bowel syndrome (IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have ch...

Objective: To systematically review the literature regarding the epidemiology of functional constipation and functional nonretentive fecal incontinence (FNRFI) in children. Secondary objectives were to assess the geographical, age, and sex distribution of functional constipation and FNRFI and to evaluate associated factors. Study design: The Coc...

Assessment of lung function using spirometry is crucial to the management of childhood lower respiratory tract disorders. The technical aspects for spirometry in pre-school children are more or less similar to that of older children and adults. However, when assessing young children, it is essential to have a well-trained technician and a child–fri...

Abstract Background Chronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents. Methods Adolescents aged 13–18 y...

Introduction: Chronic abdominal pain is a common problem in pediatric practice. The majority of cases fulfill the Rome IV criteria for functional abdominal pain disorders (FAPDs). At times, these disorders may lead to rather serious repercussions. Area covered: We have attempted to cover current knowledge on epidemiology, pathophysiology, risk fact...

Background Childhood and adolescent obesity (AO) is an emerging problem in many developing countries. AO predisposes to insulin resistance, type 2 diabetes, hypertension, hyperlipidemia and liver disease, as well as progression to obesity and cardiovascular disease in adulthood. AO is a complex disorder, with genetics, metabolism, lifestyle, and e...

Background: Nonalcoholic fatty liver disease (NAFLD) is a common problem across the world. We aimed to determine the prevalence of NAFLD and its associations in Sri Lankan adolescents living in an urban Sri Lankan community. Method: The study population consisted of the birth cohort of the year 2000, residing in the Ragama Medical Officer of Health...

Objectives: The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs). Methods: One hundred children (aged 5-12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment. Primary ou...

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 c...

Background: Community based data on childhood obesity is lacking. We investigated community prevalence and associations for adolescent obesity. Methods: 14-year-olds(Year-2000 birth-cohort), from Ragama MOH area were included. Demographic and life style data was collected. Standard blood biochemistry was performed. Physical activity (PA) and se...

Background Somatic symptoms in children constitute a major burden in hospital settings and outpatient departments. Somatic symptoms are often a manifestation of internalization of symptoms in children with distress or anxiety spectrum disorders. Furthermore, since cultural background influences the ways in which a person manifests distress, the inf...

Objectives: To determine the prevalence and risk factors for functional constipation (FC) in adolescent Nigerians. Method: A cross-sectional study was conducted in rural and urban areas of two states in the southern part of Nigeria. Adolescents aged 10-18 years were recruited from 11 secondary schools, using a stratified random sampling techniqu...

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-FGID...

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....

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 con...

Functional constipation (FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence (0.7%-29%) worldwide, both in deve...

Objectives To assess psychological maladjustment in adolescents with functional constipation. Study design We conducted a cross-sectional survey in five schools. Adolescents aged between 13 and 18 years were included in the study. Validated questionnaires were used to collect bowel habits and demographic data, health-related quality of life (HRQoL...

Objective: The aim of this study is to compare functional constipation (FC) and constipation predominant irritable bowel syndrome (IBS-C) in adolescents. Method: A school based survey was conducted involving adolescents aged 13-18 years. A set of validated questionnaires including Rome III questionnaire for functional gastrointestinal disorders...

Background: Approximately 0.2-1 % of children suffers from abdominal migraine (AM). Pathophysiology of AM has not been adequately studied. This study evaluated gastric motility in children with AM. Methods: Seventeen children (6 boys), within an age range of 4-15 years, referred to a tertiary care paediatric unit, North Colombo Teaching Hospital...

Introduction: There is evidence that overweight children have a higher prevalence of functional gastrointestinal disorders (FGIDs) than normal-weight children. Objective of this study was to assess the effects of body mass index (BMI) on gastric motility abnormalities in children with abdominal pain-predominant FGIDs (AP-FGIDs). Methods: Gastric...

Aims: The aim of this study was to evaluate the association between faecal incontinence (FI), child abuse, somatization and health- related quality of life (HRQoL) in adolescents. Methods: Adolescents (aged 13-18 years) were selected from four semi-urban schools in the Gampaha district, Sri Lanka. A validated, self-administered questionnaire was...

Objectives: To determine the prevalence, pattern, and predisposing factors of abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) in adolescent Nigerians. Methods: A cross-sectional study was conducted in 2 states in the southern part of Nigeria in June 2014. Adolescents of age 10 to 18 years were recruited from 11 second...

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-treat...

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 cchildren aged 13-18 years were selected after obtaining written consent from parents, school a...

Background: Abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are a common public health problem in children. The precise aetiology of AP-FGIDs is far from clear. Psychological stress and all forms of child abuse are known predisposing factors to develop AP-FGIDs. The main objective of this study is to study the associati...