Lack of Seasonal Variation in the Endoscopic Diagnoses of Crohn's Disease and Ulcerative Colitis

Oregon Health and Science University, Portland, Oregon, United States
The American Journal of Gastroenterology (Impact Factor: 10.76). 11/2005; 100(10):2233-8. DOI: 10.1111/j.1572-0241.2005.50127.x
Source: PubMed


Conflicting data have been reported about the seasonal variation of inflammatory bowel diseases (IBD). The purpose of the present analysis was to assess the occurrence of seasonal variations in the endoscopic diagnosis of Crohn's disease (CD) and ulcerative colitis (UC).
The Clinical Outcomes Research Initiative (CORI) uses a computerized endoscopic report generator to collect endoscopic data from 73 diverse practice sites throughout the United States. We utilized the CORI database to analyze the date-specific occurrence of colonoscopy, as well as the colonoscopic diagnoses of CD and UC. Time trends were analyzed by autocorrelation, linear, and nonlinear regression.
Between January 2000 and December 2003, the number of colonoscopies increased 4.1-fold. The proportion of colonoscopies with a CD diagnosis fell by 28%, and the proportion of colonoscopies with a UC diagnosis fell by 50%. The occurrence of neither CD nor UC was shaped by any clear-cut seasonal periodicity. However, the trends of the two diseases revealed strikingly similar patterns with four resembling peaks superimposed on their monthly fluctuations.
Endoscopic diagnosis of IBD is unaffected by any seasonal variation. The decline in the diagnostic rate of colonic IBD may reflect a relative increase in the utilization of colonoscopy for colon cancer screening. The similarity in the monthly fluctuations of both IBD suggests that their incidence or flare-ups may be influenced by identical exogenous risk factors.

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Available from: Amnon Sonnenberg, Jul 10, 2014
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    • "Several studies have reported seasonal variations in the flare of IBD, previously (Mee and Jewell, 1978; Rampton et al., 1983; Isgar et al., 1983; Sellu, 1986; Riley et al., 1990; North et al., 1991; Tysk and Jarnerot, 1993). However, very few studies, all performed in Western countries, investigated seasonality in the onset of IBD (Auslander et al., 2005; Evans and Acheson, 1965; Cave and Freedman, 1975; Don and Goldacre, 1984; Myszor and Calam, 1984; Sonnenberg et al., 1994; Moum et al., 1996; Aratari et al., 2006). The studies reported conflicting results with a peak from August to January for UC, and no seasonality for CD previously (Mee and Jewell, 1978; Rampton et al., 1983; Isgar et al., 1983; Sellu, 1986; Riley et al., 1990; North et al., 1991; Tysk and Jarnerot, 1993). "
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    ABSTRACT: Environmental factors are believed to trigger the onset of Inflammatory bowel disease (IBD). We aimed to evaluate the seasonal variation in the onset of symptoms in patients with IBD and health care seeking behaviour. 282 patients were chosen from the charts. Demographic features, the month and the age at the onset of presenting symptoms and delayed diagnosis term for each patient were analyzed. Cumulative monthly averages analysed by Kruskal Wallis test and Roger's test. Of the 282 patients with IBD, 181 were male (64%). Mean age was 40.1±14.7 years (median: 38, range: 14 to 79 years). The seasonal pattern showed peak in March with 57% and the lowest point in November with 36% (p <0.05). The delayed diagnosis term was 3.0 ± 2.3 months in males vs 3.2 ± 3.2 months in females (p >0.05). The seasonal pattern was not influenced by both genders and by age groups in patients with IBD or UC or CD (p >0.05). We investigated the etiologic environment of IBD and found an interaction between the etiopathogenesis of IBD and environmental risk factors. There was a delay in IBD, but no difference on the health care seeking behaviour between males and females.
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