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| 1 | Irritable bowel syndrome in children:Current knowledge, challenges and opportunities显示文摘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 changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS. | Niranga Manjuri Devanarayana Shaman Rajindrajith | 2018 | World Journal of Gastroenterology2018，24，21： | 14 |
| 2 | Childhood constipation as an emerging public health problem显示文摘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 developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities. | Shaman Rajindrajith Niranga Manjuri Devanarayana Bonaventure Jayasiri Crispus Perera Marc Alexander Benninga | 2016 | World Journal of Gastroenterology2016，22，30： | 10 |
| 3 | Autonomic functions and gastric motility in children with functional abdominal pain disorders显示文摘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 pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain(P < 0.05).Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(P< 0.05).CONCLUSION Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction. | Amaranath Karunanayake Shaman Rajindrajith Hitanadura Asita de Silva Sampath Gunawardena Niranga Manjuri Devanarayana | 2019 | World Journal of Gastroenterology2019，25，1： | 3 |
| 4 | Influence of non‐alcoholic fatty liver disease on the development of diabetes mellitus显示文摘 | Anuradhani Kasturiratne Sanjaya Weerasinghe Anuradha S Dassanayake Shaman Rajindrajith Arjuna P Silva Norihiro Kato A Rajitha Wickremasinghe H Janaka Silva | 2012 | J Gastroenterol Hepatol2012，，1： | 2 |
| 5 | Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study显示文摘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 selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs. | Manori Vijaya Kumari Niranga Manjuri Devanarayana Lakmali Amarasiri Shaman Rajindrajith | 2018 | World Journal of Clinical Cases2018，6，15： | 2 |
| 6 | Constipation in children : nov- el insight into epidemiology, pathophysiology and manage- ment 显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neurogastroenterol Motil2011，1，： | 1 |
| 7 | Constipation in children: novel insight into epidemiology,pathophysiology and management显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neurogastroenterol Motil2011，17，1： | 1 |
| 8 | Prevalence of Acanthosis Nigricans in an urban population in Sfi Lanka and its utility to detect metabolic syndrome显示文摘 | Dassanayake AS Kasturiratne A Niriella MA Kalubovila U Rajindrajith S de Silva AP | 2011 | BMC Res Notes2011，4，1： | 1 |
| 9 | Constipation in children : novel insight into epidemiology,pathophysiology and management显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neurogastroen- terol Motil2011，17，1： | 1 |
| 10 | Constipation in children: novel in-sight into epidemiology, pathophysiology and management 显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neu-rogastroenterol Motil2011，17，1： | 1 |
| 11 | Constipation in children : novel in-sight into epidemiology, pathophysiology and management 显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neu-rogastroenterol Motil2011，17，1： | 1 |
| 12 | Constipation in children:novel insight into epidemiology,pathophysiology and management显示文摘 | Rajindrajith S Devanarayana NM | 2011 | Journal of Neurogastroenterology&Motility2011，46，： | 1 |
| 13 | Preva- lence and risk factors for non - alcoholic fatty liver di-sease among adults in an urban Sri Lankan population 显示文摘 | Dassanayake AS Kasturiratne A Rajindrajith S | 2009 | J Gastroenterol Hep- atol2009，24，7： | 1 |
| 14 | Recurrent abdominal pain in children 显示文摘 | Devanarayana NM Rajindrajith S de Silva HJ | 2009 | Indian Pediatr2009，46，5： | 1 |
| 15 | Association between constipation and stressful life events in a cohort of Sri Lankan children and adolescents 显示文摘 | Devanarayana NM Rajindrajith S | 2010 | J Trop Pediatr2010，56，3： | 1 |
| 16 | Constipation-associated and nonretentive fecal incontinence in children and adolescents:an epidemiological survey in Sri Lanka显示文摘 | Rajindrajith S Devanarayana NM Benninga MA | 2010 | J Pediatr Gastroenterol Nutr2010，51，4： | 1 |
| 17 | Constipation in children: novel insight into epidemiology, pathophysiology and manage- ment 显示文摘 | Rajindrajith S Devanarayana NM | 2011 | J Neuro-gastroenterol Motil2011，1，： | 1 |
| 18 | Quality of life and health care consultation in 13 to 18 year olds with abdominal pain pre- dominant functional gastrointestinal diseases 显示文摘 | Devanarayana NM Rajindrajith S Benninga MA | 2014 | BMC Gastroenterol2014，21，14： | 1 |
| 19 | Constipation in children: novel insight into epidemiology, pathophysiology and man- agement显示文摘 | Rajindrajith S Devauarayana NM | 2011 | Journal of neurogastroenterology and motility2011，17，1： | 1 |
| 20 | Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management 显示文摘 | Rajindrajith S Devanarayana NM Benninga MA | 2013 | Mimentary pharmacology & therapeutics2013，37，1： | 1 |
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