Seasonal Patterns of Hospital Treatment for Inflammatory Bowel Disease in Italy

Abstract

Aim: It is still debated whether clinical flare-ups of chronic inflammatory bowel disease follow a seasonal pattern, and the various reports are based on general practitioners’ records or hospital discharge charts. There are, however, no specific figures for treatment in hospital gastroenterology units, which serve as a reference point for these disorders. This study was therefore designed to investigate whether there is a seasonal pattern in admissions for inflammatory intestinal disease in Italy, differing from what is generally known about gastrointestinal pathologies, since there are no nation-wide figures on the subject. Methods: The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 22 centers in Italy. Results: From winter 2000 to autumn 2003, the 22 gastroenterology units participating in the RING project discharged 32,357 patients following ordinary hospital admissions. Of these, 2,856 (8.8%) had a main diagnosis of inflammatory bowel disease: 1,541 Crohn’s disease, and 1,315 ulcerative colitis. No seasonal patterns were detected for either category, or when the analysis was done by age, sex and site of disease. Conclusions: The most serious flare-ups of inflammatory bowel disease, i.e. those requiring routine hospital treatment, do not appear to follow any seasonal pattern, regardless of the site of the disease or the patient’s age or sex.

Seasonality and Pediatric Inflammatory Bowel Disease

“…Studies have found that UC exacerbations can peak in any season, including the fall (5)(6)(7)(8)(9), winter (5)(6)(7), spring (8)(9)(10)(11), or summer (11). Others have found no association between season of the year and hospital admissions (12)(13)(14)(15). CD exacerbations have been reported to peak in the fall and winter (16), although the majority of studies have not found any seasonality of disease activity (5,10,(12)(13)(14)(15).…”

Effects of temperature, weather, seasons, atmosphere, and climate on the exacerbation of inflammatory bowel diseases: A systematic review and meta-analysis

“…Cohort studies (three studies) were published only as conference abstracts, and a meta-analysis could not be performed owing to the lack of raw data for meta-analysis. Furthermore, only 6 out of 20 studies reported information on the duration of IBD morbidity, location of lesions, or medications administered [ 20 – 24 , 50 ]. Moreover, 7 out of 20 studies did not report the number of patients who experienced IBD exacerbations [ 18 , 20 , 26 , 27 , 49 , 51 , 52 ], and 6 of the 11 studies reported different numbers of patients and cases of exacerbations [ 19 , 21 , 22 , 25 , 48 , 50 ].…”

“…Our study included a total of 20 studies on the effects of temperature, weather, season, and atmosphere on the exacerbation of IBD [18][19][20][21][22][23][24][25][26][27][45][46][47][48][49][50][51][52][53][54], and a meta-analysis of the correlation…”

“…information on the duration of IBD morbidity, location of lesions, or medications administered [20][21][22][23][24]50]. Moreover, 7 out of 20 studies did not report the number of patients who experienced IBD exacerbations [18,20,26,27,49,51,52], and 6 of the 11 studies reported different numbers of patients and cases of exacerbations [19,21,22,25,48,50].…”

“…In contrast, a largescale cohort study in Sweden showed a significant correlation of the onset of IBD symptoms with the season or month of birth [15,16]. Thereafter, some case-series showed that exacerbation was significantly related to a specific month in pediatric or adult UC patients [17], although subsequent studies on IBD exacerbation provided conflicting results [18][19][20][21][22][23][24][25][26][27].…”