Browsing by Author "Ferdinandis, T.G.H.C."

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Chronic alcoholism and esophageal motor activity: a 24-h ambulatory manometry study
(Blackwell Scientific Publications, 2006) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
BACKGROUND: Stationary esophageal manometry has shown esophageal motor abnormalities in patients with chronic alcoholism. The abnormalities identified in different studies are not consistent. Twenty-four hour ambulatory esophageal manometry enables monitoring of esophageal motor activity under a variety of physiological conditions and gives a more complete assessment. METHOD: Twenty-four hour ambulatory esophageal manometry and pH-metry were performed using a combined pH and pressure catheter. Subjects with chronic alcoholism with no other illness and not in withdrawal were studied with age- and sex-matched healthy controls. Autonomic nerve functions tests were performed in all subjects. RESULTS: Twenty-three chronic alcoholic subjects and 12 control subjects completed the study. The median ethanol consumption was 95 g/day (range 75 -175 g/day) for 12 years (range 5-30 years) among alcoholic subjects. Eight alcoholic subjects had heartburn and regurgitation but none had dysphagia. Ten (43%) alcoholic subjects had autonomic neuropathy and four (17%) had increased gastroesophageal acid reflux. Lower esophageal sphincter hypertension was observed in alcoholic subjects with autonomic neuropathy. Esophageal body motility parameters (i.e. frequency, duration, amplitude and percentage of peristaltic waves) were not significantly different between alcoholic subjects and controls. CONCLUSIONS: Results of ambulatory esophageal manometry on subjects with chronic alcoholism seem to indicate that long-term ethanol intake has no major effects on esophageal motor activity other than lower esophageal sphincter hypertension among those with alcoholic autonomic neuropathy
Effect of carbohydrates meals for varying consistency on gastric myoelectrical activity
(Singapore Medical Association, 2002) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
BACKGROUND: There is at present no agreement on the type of test meal to be used when performing EGG. To our knowledge the response of thestomach to high carbohydrate isocaloric meals of different consistencies has not been formally assessed. AIM: To study 1) the effects of high carbohydrate meals of varying consistency on EGG activity; and 2) the effects of increasing the calorie content of a meal without changing its consistency and composition on the postprandial EGG. SUBJECTS: Eighteen healthy volunteers, six males (age: 21-35 year, weight: 45-60 kg) and 12 females in the follicular phase of the menstrual cycle (age: 24-30 years, weight: 45-55 kg). METHODS: Following an overnight fast subjects were given three high carbohydrate, low fat, isocaloric meals (165-170 kcal) of different consistencies (solid, semisolid, liquid), on three separate days in a random order. The liquid and semisolid meals were equal in volume (200 ml) while the volume of the solid meal was smaller. One hour EGG recordings were done in the fasting and fed states in each subject. As a second step, ten of the above volunteers (taken randomly) were given the solid test meal on a separate day after increasing the calorie content of the meal to 350 kcal. RESULTS: The power of the EGG at the dominant frequency significantly increased after solid (175 kcal meal: fasting 49 +/- 12 dB vs. fed 57 +/- 13 dB; p < 0.05, 375 kcal meal: fasting 48.5 +/- 12.9 dB vs fed 58.1 +/- 11.7 dB) and semisolid (fasting 50 +/- 12 dB vs. fed 55 +/- 13; P < 0.05). The increase in power was not significantly different when fed with solids and semisolids. There was no statistically significant change in EGG power during the first 15 or 60 minutes after the liquid meal. Feeding showed no significant effect on the dominant frequency and the percentage of 2-4 cpm waves of the EGG with any of the three types of test meals. CONCLUSIONS: Solid and semisolid meals high in carbohydrate and low in fat are capable of inducing a significant increase in the EGG power in normal subjects. Isocaloric solid and semisolid meals have similar effects on gastric slow wave activity. EGG appears unaffected by the liquid meal. Therefore only an increase in the power of the EGG can be regarded as normal if a high carbohydrate solid or a semisolid meal is given as the test meal when performing an EGG.
Electrogastrographic observations in healthy adults
(Sri Lanka Medical Association, 1998) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
INTRODUCTION : Electrogastrography (EGG) is a recently developed non invasive technique of recording gastric myoelectrical activity. Normal values of EGG parameters are yet to be clearly defined. There are suggestions that the values may vary due to factors such as gender and ethnicity. AIM : To determine normal values for several EGG parameters in healthy Sri - Lankan volunteers in the fasting and fed state, and we also hypothesized that, there are significant differences in these between the two sexes. METHOD : EGG was performed in 17 healthy volunteers, 8 males(age 21 -60 yr.) and 9 females(age 24 - 46 yr.) in the follicular phase for one hour each in the fasting and the fed states. Result were analyzed using the statistical package Epilnfo. RESULTS : The mean gastric electrical frequency was 2.65 + 0.67 cpm in the fasting and 2.69 + 0.75 in the fed state. The dominant frequency was in the 2 -4 cpm range in 15 (88.2%) subjects in the fasting and in 14(87.5%) in the fed state respectively. These differences were not statistically significant. Feeding caused an increase in the power of the dominant frequency by 19 - 4600 uV2 in 12(75%) subjects. The above results did not differ significantly between the two sexes. CONCLUSIONS : The dominant gastric electrical frequency in Sri Lankans was consistent with previously reported data from other countries. Increase in EGG power after a solid meal was confirmed by the study. Although a gender difference in EGG parameters has been reported previously, our reports failed to demonstrate such a difference.
Illicit alcohol consumption and Neuropathy - a Preliminary Study in Sri Lanka
(Oxford University Press, 2008) Ferdinandis, T.G.H.C.; de Silva, H.J.
AIMS: To compare the effects on peripheral and autonomic nerve functions of Sri Lankan illicitly distilled alcohol consumption versus legal spirit consumption. METHODS: Peripheral nerve conduction and autonomic nerve functions were assessed in 40 healthy control subjects and two groups of chronic heavy drinkers: 41 illicit spirit drinkers and 17 legal spirit drinkers. RESULTS: Lower-limb motor and sensory nerve conduction parameters were affected in both groups of alcoholics. When compared with controls, in illicit spirit drinkers the mean heart rate indexes of all parasympathetic tests were lower while in legal spirit drinkers the heart rate response to standing was affected. There were no differences in the results of the above tests when the two groups of heavy drinkers were compared. CONCLUSIONS: Though chronic alcoholism results in peripheral and autonomic nerve damage, the damage caused by consumption of illicitly distilled spirit is not worse than the damage caused by consumption of legal spirits.
Use of ambulatory oesophageal pH monitoring to diagnose gastrooesophageal reflux disease
(Sri Lanka Medical Association, 2007) Ferdinandis, T.G.H.C.; Amarasiri, D.L.; de Silva, H.J.
OBJECTIVES: To investigate the characteristics of patients referred for ambulatory oesophageal pHmetry, the referral pattern, and the role of oesophageal pHmetry as a diagnostic tool in a tertiary care hospital in Sri Lanka. DESIGN: Data obtained from patients referred to the Gastrointestinal Research Laboratory at Teaching Hospital Ragama for 24-hour ambulatory oesophageal pHmetry from 1998 to 2005 were reviewed. Patients' upper gastrointestinal endoscopy reports and stationary oesophageal manometry reports were also reviewed. RESULTS: 140 pHmetry studies were performed during the study period. The majority of patients (> 90%) were referred by specialists in gastroenterology practicing in hospitals in or around Colombo. There were 88 males and the median age was 37 years (range 0.5-74). The median duration of symptoms was 4.1 years (range 0.2 -25). Typical symptoms of gastro-oesophageal reflux disease (GORD) were present in 53 (38%) patients, atypical symptoms of GORD in 31 (22%), and nonspecific upper gastrointestinal symptoms in 56 (40%). Pathological acid reflux was found in 43 (31%) patients. Of them, 29 (67%) had typical GORD symptoms, 7 (16%) had atypical symptoms, and 7 (16%) had non-specific upper gastrointestinal symptoms. No significant association was found between endoscopy and pHmetry results. CONCLUSION: Oesophageal pH monitoring helped to establish a cause for the morbidity in a significant number of patients with GORD symptoms, but not in the majority of patients referred for the test. In our experience the investigation does not seem to be optimally used as a diagnostic tool.