Seasonal clustering in inflammatory bowel disease: a single centre experience

Başaranoğlu, Metin; Sayılır, Abdurrahim; Demirbağ, Ali Eba; Mathew, Sanju; Ala, Aftab; Şentürk, Hakan

doi:10.1586/17474124.2015.1025054

Cited by 11 publications

(11 citation statements)

References 20 publications

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“…The mean age at diagnosis in our study was 37 years. This finding follows results from Rio de Janeiro for both IBDs (36.7 years) (15) , as well as results from São Paulo (35-36 years) (17) and other countries such as Colombia (37.3 years), the Netherlands (34 years) (18) and Asia (36.3 years) (24) . Our data confirmed a trend showing a younger mean age at diagnosis for CD than for UC.…”

Section: Discussionsupporting

confidence: 88%

“…Our study contributes as a pioneering evaluation of this subject in Brazil. The majority of patients in our study had UC (54%), following the trend of other Brazilian studies (14)(15)(16)(17) and studies from other countries in Latin America (18)(19)(20) , the USA (21,22) , Asia (83.2% UC) (23) , France (64% UC) (24) and Denmark (54% UC) (25) . One study from North America demonstrated that UC is more common in the Hispanic population (26) .…”

Section: Discussionsupporting

confidence: 86%

“…The two diseases were more prevalent among females, following the trend in other countries (19,24,26,29,30) . The mean age at diagnosis in our study was 37 years.…”

Section: Discussionmentioning

confidence: 69%

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The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients

Nóbrega

Silva

Brito

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: The diagnosis of inflammatory bowel disease is often delayed because of the lack of an ability to recognize its major clinical manifestations. OBJECTIVE: Our study aimed to describe the onset of clinical manifestations in inflammatory bowel disease patients. METHODS: A cross-sectional study. Investigators obtained data from interviews and the medical records of inflammatory bowel disease patients from a reference centre located in Brazil. RESULTS: A total of 306 patients were included. The mean time between onset of symptoms and diagnosis was 28 months for Crohn’s disease and 19 months for ulcerative colitis. The main clinical manifestations in Crohn’s disease patients were weight loss, abdominal pain, diarrhoea and asthenia. The most relevant symptoms in ulcerative colitis patients were blood in the stool, faecal urgency, diarrhoea, mucus in the stool, weight loss, abdominal pain and asthenia. It was observed that weight loss, abdominal pain and distension, asthenia, appetite loss, anaemia, insomnia, fever, nausea, perianal disease, extraintestinal manifestation, oral thrush, vomiting and abdominal mass were more frequent in Crohn’s patients than in ulcerative colitis patients. The frequencies of urgency, faecal incontinence, faeces with mucus and blood, tenesmus and constipation were higher in ulcerative colitis patients than in Crohn’s disease patients. The mean time from the onset of clinical symptoms to the diagnosis of Crohn’s disease was 37 months for patients with ileocolonic location, 26 months for patients with ileum location and 18 months for patients with colon location. In ulcerative colitis patients, the mean time from the onset of symptoms to diagnosis was 52 months for proctitis, 12 months for left-sided colitis and 12 months for extensive colitis. CONCLUSION: Ulcerative colitis presented a high frequency of intestinal symptoms, and Crohn’s disease showed a high frequency of systemic manifestations at the onset of manifestation. There was a long delay in diagnosis, but individuals with more extensive disease and more obvious symptoms showed a shorter delay.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 86%

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The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients

Nóbrega

Silva

Brito

et al. 2018

Arq. Gastroenterol.

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“…Finally, from the16 studies examining UC, median diagnostic delay ranged from 2 to 55.2 months, with two thirds of studies reporting delay between 2 to 6 months. This overall longer median delay observed in patients with CD compared to UC was also observed in the subset of studies where delay had been directly compared between the two conditions within the same populations [5,7,13,21,24,34].…”

Section: Extent Of Diagnostic Delaysupporting

confidence: 57%

Diagnostic Delay in Adult Inflammatory Bowel Disease: A Systematic Review

Cross

Saunders

Farmer

et al. 2022

Preprint

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Background The extent of diagnostic delay in inflammatory bowel disease (IBD) is incompletely understood. We aimed to understand the extent of diagnostic delay of IBD in adults and identify associations between patient or healthcare characteristics and length of delay. Methods Articles were sourced from EMBASE, Medline and CINAHL from inception to April 2021. Inclusion criteria were adult cohorts (18 ≥ years old) reporting median time-periods between onset of symptoms for Crohn’s disease (CD), ulcerative colitis (UC) or IBD (i.e., CD and UC together) and a final diagnosis (diagnostic delay). Narrative synthesis was used to examine the extent of diagnostic delay and characteristics associated with delay. Sensitivity analysis was applied by the removal of outliers. Results Thirty-one articles reporting median diagnostic delay for IBD, CD or UC were included. After sensitivity analysis, the majority of IBD studies (7 of 8) reported a median delay of between 2-5.3 months. From the studies examining median delay in UC, three quarters (11 of 16) reported a delay between 2–6 months. In contrast, three quarters of the studies (17 of 23) including CD samples, reported a delay of between 2–12 months. No characteristic had been examined enough to understand their role in diagnostic delay in these populations. Conclusions This systematic review provides robust insight into the extent of diagnostic delay in IBD, particularly in CD, and suggests further intervention is needed to reduce delay. Furthermore, our findings provide a benchmark value range, which such future work can be measured against.

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“…Such effects have been previously shown for IBS and IBD symptoms. 25 26 However, there was a significantly greater effect of vitamin D intervention than placebo on circulating vitamin D. Taken together, these data suggestion that seasonal variation should also be taken into account in the design of trials to assess the potential application of vitamin D in IBS.…”

Section: Discussionmentioning

confidence: 85%

Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial

Tazzyman

Richards

Trueman

et al. 2015

BMJ Open Gastroenterol

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BackgroundVitamin D deficiency has been associated or implicated with the pathophysiology of the gastrointestinal conditions inflammatory bowel disease and colorectal cancer, as well as with depression. No trials or epidemiology studies to date have investigated a link with irritable bowel syndrome (IBS). A single case report has suggested a benefit in IBS of vitamin D supplementation. We hypothesised that IBS participants with vitamin D insufficiency would benefit from repletion in terms of their IBS symptoms. We undertook a pilot trial to provide data to support a power calculation and to justify a full trial.MethodsThis was a randomised, double blinded, three-arm parallel design trial of vitamin D, placebo or a combination of vitamin D and probiotics. Participants were further stratified according to whether they were vitamin D replete or insufficient. Vitamin D status was determined by blood test at baseline and exit; IBS symptoms were assessed by validated questionnaire; dietary intakes were assessed by food frequency questionnaire.ResultsA significant proportion of the IBS population were vitamin D deficient, such that the replete stratum could not be adequately recruited. There was a significant association in the baseline data between circulating vitamin D level and quality of life (“How much has IBS affected your life?”). Supplementation significantly improved vitamin D level versus placebo. IBS symptoms were not significantly improved in this pilot, although a power calculation was enabled from the intervention data.ConclusionsThe IBS population exhibits significant levels of vitamin D insufficiency and would benefit from screening and possible supplementation. The impact of IBS on quality of life may be reduced by vitamin D level. Future trials should have a sample size of over 97.Trial registration number:ICTRN 6116003917.

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Seasonal clustering in inflammatory bowel disease: a single centre experience

Abstract: Our results show a seasonal relation in IBD cases, particularly in CUC, which may suggest external stimuli acting as a precipitant to IBD in susceptible individuals. There was a delay between symptom onset and CUC diagnosis, which was not felt to be clinically significant.

Cited by 11 publications

References 20 publications

The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients

The Onset of Clinical Manifestations in Inflammatory Bowel Disease Patients

Diagnostic Delay in Adult Inflammatory Bowel Disease: A Systematic Review

Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial

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