Browsing by Author "Duminda, H.K.K.T."

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Is osteoporosis more common among adult Sri Lankans with inflammatory bowel disease (IBD)?
(Sri Lanka Medical Association, 2008) de Silva, A.P.; Karunanayake, A.L.; Dissanayaka, T.G.I.; Dassanayake, A.S.; Duminda, H.K.K.T.; Pathmeswaran, A.; de Silva, H.J.
BACKGROUND: IBD is a recognized risk factor for osteoporosis among Caucasians. Although the incidence of IBD seems to be increasing in Asians, there are no data on osteoporosis in Asian patients. Objective: To determine whether osteoporosis is more common among adult Sri Lankans with IBD. DESIGN, SETTING AND METHODS: Consecutive patients with previously diagnosed IBD who were older than 30 years and age and sex matched controls from the general population (3 controls for I patient) were screened for osteoporosis using a previously validated peripheral DEXA scan. Patients who were pregnant, had other significant co-morbidities, were on caicium supplements or on treatment for osteoporosis within the past 6 months were excluded. RESULTS: There were 86 IBD patients (55 females, mean age 46.4 years) and 258 controls (165 females, mean age 47.3 years). Osteoporosis was significantly more common among IBD patients (14.7%) than controls (6.5%) (P=0.048). Increasing age (P=0.019), female gender (P=O.OOS), menopause (P=0.022) and use of systemic steroids (P= 0.008) were found to be significantly associated with osteoporosis among JBD patients, while severity of disease (PKK470), number of relapses (P=0.391), duration of illness (P=0.540) and treatments other than systemic steroids (P=0.434) were not. Osteoporosis did not differ significantly between patients with ulcerative colitis (14.28%) and Crohn's disease (15.79%) (P=0.891). CONCLUSION: Osteoporosis is more common among adult Sri Lankans with IBD than community controls. The use of systemic steroids is a disease related independent risk factor for development of osteoporosis in these patients.
Microscopic colitis not otherwise specified (NOS) in patients with diarrhoea predominant IBS in a tropical setting
(Sri Lanka Medical Association, 2008) de Silva, A.P.; Dassanayake, A.S.; Hewavisenthi, J.; Liyanage, D.L.M.N.; Dissanayake, T.G.I.; Duminda, H.K.K.T.; de Silva, H.J.
BACKGROUND: Coionoscopy is not recommended in IBS unless there are alarm symptoms. However, studies have shown that microscopic colitis and low grade inflammatory bowel disease (IBD) can mimic IBS. Microscopic colitis not otherwise specified (MNOS) is a distinct but poorly studied entity, especially in the tropics. OBJECTIVES: To investigate the presence of colonic and ileal inflammation in patients with diarrhea predominant IBS (IBS-D) in a tropicai setting. DESIGN, SETTING AND METHODS: In a prospective study over one year, we recruited 42 consecutive patients with IBS (diagnosed using Rome II criteria) and no alarm symptoms (mean age 36.1 yrs, M:F=29:13) and 13 controls {mean age 42.3 yrs, M:F=5:8). Serial colonic and ileal biopsies were obtained. RESULTS: Coionoscopy was macroscopically normal in all cases and controls. 23 (54.8%) cases had MNOS, 2(4.76%) ileal inflammation only, and 17(40.48%) had normal histology. Histology was normal in 11(84.62%) controls, and 2(15.38%) had MNOS. MNOS was significantly commoner in cases than controls (P=0.02, chi-square test). MNOS was commonest in the right side of the colon (n=20, 80%). 14(60.8%) patients with MNOS had a history suggestive of post infective IBS, compared to 7(36.8%) patients without MNOS (P>0.05). CONCLUSION: MNOS is common in patients with IBS-D in a tropical setting. Post infectious IBS seems commoner in patients with MNOS than those without MNOS, although this did not reach statistical significance. Coionoscopy with ileoscopy and serial biopsies are useful to detect mucosal inflammation in IBS-D.