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

BACKGROUND: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).METHODS: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.RESULTS: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.CONCLUSIONS: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.

[1]  A. Sonnenberg,et al.  Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. , 2004, Gastroenterology.

[2]  W. Bilker,et al.  Seasonal variation in flares of inflammatory bowel disease. , 2004, Gastroenterology.

[3]  M. Cowen,et al.  The impact of a celebrity promotional campaign on the use of colon cancer screening: the Katie Couric effect. , 2003, Archives of internal medicine.

[4]  Hermann Brenner,et al.  Cost-effectiveness of colonoscopy in screening for colorectal cancer. , 2002, Archives of internal medicine.

[5]  D. Lieberman,et al.  Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. , 2000, The New England journal of medicine.

[6]  F A Boddy,et al.  Seasonal variation in mortality in Scotland. , 2000, International journal of epidemiology.

[7]  G. Paspatis,et al.  Seasonal variation in exacerbations of ulcerative colitis. , 1997, Hepato-gastroenterology.

[8]  M. Manthey,et al.  Cryptosporidiosis and Inflammatory Bowel Disease (Experience from the Milwaukee Outbreak) , 1997, Digestive Diseases and Sciences.

[9]  F. Casellas,et al.  Seasonal influence in exacerbations of inflammatory bowel disease. , 1997, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva.

[10]  S. Kivelä,et al.  Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland. , 1996, Arctic medical research.

[11]  M. Vatn,et al.  Seasonal variations in the onset of ulcerative colitis. , 1996, Gut.

[12]  T M Allan,et al.  Seasonal variation in coronary heart disease in Scotland. , 1995, Journal of epidemiology and community health.

[13]  A. Sonnenberg,et al.  Periodicity of hospital admissions for inflammatory bowel disease. , 1994, The American journal of gastroenterology.

[14]  A. Sonnenberg,et al.  Monthly variation of hospital admission and mortality of peptic ulcer disease: a reappraisal of ulcer periodicity. , 1992, Gastroenterology.

[15]  A. Sonnenberg,et al.  Epidemiology of inflammatory bowel disease among U.S. military veterans. , 1991, Gastroenterology.

[16]  J. Brody,et al.  Seasonal variation in the incidence of hip fracture among white persons aged 65 years and older in the United States, 1984-1987. , 1991, American journal of epidemiology.

[17]  J. Paulley,et al.  Reply , 1990, Gut.

[18]  J. Walker-Smith,et al.  A prospective study of viral and mycoplasma infections in chronic inflammatory bowel disease. , 1990, Gastroenterology.

[19]  D. Sellu.  Seasonal variation in onset of exacerbations of ulcerative proctocolitis. , 1986, Journal of the Royal College of Surgeons of Edinburgh.

[20]  Jonathan D. Cryer,et al.  Time Series Analysis , 1986 .

[21]  M. Goldacre,et al.  ABSENCE OF SEASONALITY IN EMERGENCY HOSPITAL ADMISSIONS FOR INFLAMMATORY BOWEL DISEASE , 1984, The Lancet.

[22]  J. Calam,et al.  SEASONALITY OF ULCERATIVE COLITIS , 1984, The Lancet.

[23]  H. Greenberg,et al.  Acute viral enteritis and exacerbations of inflammatory bowel disease. , 1982, Gastroenterology.

[24]  D. Jewell,et al.  Factors inducing relapse in inflammatory bowel disease. , 1978, British medical journal.

[25]  P. Young,et al.  Time series analysis, forecasting and control , 1972, IEEE Transactions on Automatic Control.

[26]  D. Lieberman,et al.  Colonoscopy practice patterns since introduction of medicare coverage for average-risk screening. , 2004, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[27]  A. Sonnenberg,et al.  Commonalities in the time trends of Crohn's disease and ulcerative colitis , 1999, American Journal of Gastroenterology.

[28]  F. Anderson,et al.  Seasonal change in the exacerbations of Crohn's disease. , 1996, Scandinavian journal of gastroenterology.

[29]  G. Järnerot,et al.  Seasonal variation in exacerbations of ulcerative colitis. , 1993, Scandinavian journal of gastroenterology.

[30]  P. W. Strike,et al.  Forecasting and control , 1991 .

[31]  J. A. Bargen,et al.  RELAPSES IN CHRONIC ULCERATIVE COLITIS: CAUSES AND PREVENTION , 1934 .