Manabu Araki1, Shinichiro Shinzaki1, Takuya Yamada2, Shoko Arimitsu3, Masato Komori4, Narihiro Shibukawa5, Akira Mukai6, Sachiko Nakajima7, Kazuo Kinoshita8, Shinji Kitamura9, Yoko Murayama10, Hiroyuki Ogawa11, Yuichi Yasunaga12, Masahide Oshita13, Hiroyuki Fukui14, Eiji Masuda15, Masahiko Tsujii16, Satoshi Hiyama1, Takahiro Inoue1, Hideki Iijima17, Tetsuo Takehara1. 1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. 2. Department of Gastroenterology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 3. Kinshukai Infusion Clinic, Osaka, Japan. 4. Department of Gastroenterology, Osaka Rosai Hospital, Sakai, Japan. 5. Department of Gastroenterology, NTT-West Osaka Hospital, Osaka, Japan. 6. Department of Gastroenterology, Sumitomo Hospital, Osaka, Japan. 7. Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan. 8. Department of Gastroenterology, Otemae Hospital, Osaka, Japan. 9. Department of Gastroenterology, Sakai City Hospital, Sakai, Japan. 10. Department of Gastroenterology and Hepatology, Itami City Hospital, Itami, Japan. 11. Department of Gastroenterology, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan. 12. Department of Gastroenterology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan. 13. Department of Internal Medicine, Osaka Police Hospital, Osaka, Japan. 14. Department of Gastroenterology, Yao Municipal Hospital, Yao, Japan. 15. Department of Gastroenterology, National Hospital Organization Osaka-Minami National Hospital, Kawachinagano, Japan. 16. Department of Gastroenterology, Higashiosaka Municipal Hospital, Higashiosaka, Japan. 17. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. hiijima@gh.med.osaka-u.ac.jp.
Abstract
BACKGROUND: Environmental factors are suggested to affect the pathogenesis of several diseases, including inflammatory bowel disease (IBD). The seasonality of disease onset and exacerbation in IBD, however, are not well established. We herein aimed to clarify the disease seasonality and to investigate the underlying characteristics in IBD patients exhibiting seasonality of the disease course. METHODS: This was a multicenter observational study comprising 20 institutions (Osaka Gut Forum) in Japan. Data were collected from November 2013 to August 2014 using survey forms for physicians and questionnaires for patients. Multivariate analysis was performed to clarify the independent factors affecting disease seasonality. RESULTS: A total of 1055 patients, including 298 patients with Crohn's disease (CD) and 757 patients with ulcerative colitis (UC), were enrolled. The proportion of CD patients with disease onset in the summer was significantly larger than that in the other seasons, while UC patients exhibited no seasonality of disease onset. More than half of the IBD patients (51.1%) experienced seasonal exacerbation of IBD, and winter was the most common season for disease exacerbation in both CD and UC patients. Seasonality of disease onset and exacerbation was observed in young-onset patients (≤40 years old), but not in elderly-onset patients. Age at onset was independently associated with the seasonality of both disease onset and exacerbation. CONCLUSIONS: Seasonality of disease onset and exacerbation was observed especially in young-onset IBD patients. Underlying pathophysiologic triggers for disease initiation and exacerbation may be influenced by age at disease onset.
BACKGROUND: Environmental factors are suggested to affect the pathogenesis of several diseases, including inflammatory bowel disease (IBD). The seasonality of disease onset and exacerbation in IBD, however, are not well established. We herein aimed to clarify the disease seasonality and to investigate the underlying characteristics in IBDpatients exhibiting seasonality of the disease course. METHODS: This was a multicenter observational study comprising 20 institutions (Osaka Gut Forum) in Japan. Data were collected from November 2013 to August 2014 using survey forms for physicians and questionnaires for patients. Multivariate analysis was performed to clarify the independent factors affecting disease seasonality. RESULTS: A total of 1055 patients, including 298 patients with Crohn's disease (CD) and 757 patients with ulcerative colitis (UC), were enrolled. The proportion of CDpatients with disease onset in the summer was significantly larger than that in the other seasons, while UC patients exhibited no seasonality of disease onset. More than half of the IBDpatients (51.1%) experienced seasonal exacerbation of IBD, and winter was the most common season for disease exacerbation in both CD and UC patients. Seasonality of disease onset and exacerbation was observed in young-onset patients (≤40 years old), but not in elderly-onset patients. Age at onset was independently associated with the seasonality of both disease onset and exacerbation. CONCLUSIONS: Seasonality of disease onset and exacerbation was observed especially in young-onset IBDpatients. Underlying pathophysiologic triggers for disease initiation and exacerbation may be influenced by age at disease onset.
Entities:
Keywords:
Age at onset; Inflammatory bowel disease; Seasonality
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