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Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases
Mahesh Z Krishna1, Keisha R Barton1, Carla M Perez1
1Section of Pediatric Gastroenterology, Baylor College of Medicine, Houston, TX.
Insights
Seasonality does not impact pediatric inflammatory bowel diseases (IBD) onset. However, IBD symptom onset correlates with academic semesters, suggesting stress may play a role in disease development.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Epidemiology
Background:
- The influence of seasonality on the onset of pediatric inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, remains largely unexamined.
- Understanding potential triggers for IBD onset is crucial for early diagnosis and management in children.
Purpose of the Study:
- To investigate whether seasonal patterns influence the onset of IBD in pediatric patients.
- To explore potential correlations between disease onset and specific annual rhythms, such as academic schedules.
Main Methods:
- Analysis of pediatric IBD patient records from 2009-2015, encompassing a discovery cohort (169 cases) and a validation cohort (122 cases).
- Determination of symptom onset month for each patient to identify potential seasonal trends.
- Statistical analysis to compare disease onset frequency across different months and seasons.
Main Results:
- No significant seasonal patterns were observed for conception, birth, or IBD symptom onset.
- A statistically significant annual rhythm of IBD symptom onset was identified, correlating with academic semesters.
- Pediatric IBD symptom onset occurred more frequently during months associated with the initiation and termination of academic semesters (August, September, January, December, May) in both cohorts.
Conclusions:
- Seasonal variations do not appear to be a significant factor in the onset of pediatric inflammatory bowel diseases.
- Academic stress, indicated by correlations with semester timings, may be a contributing factor to the symptomatic onset of IBD in children.
- These findings may aid in improving the timely diagnosis of pediatric IBD by considering environmental and stress-related factors.
Abstract:
It is currently unclear whether seasonality affects the onset of inflammatory bowel diseases (IBDs: Crohn disease and ulcerative colitis) in children. Here, we examined the records of pediatric patients with IBD diagnosed between 2009 and 2015 in a discovery cohort of 169 cases and a validation cohort of 122 subjects, where the month of symptoms onset could be determined. No seasonal patterns could be identified in respect to conception, birth, and disease onset. An annual rhythm of symptomatic onset, however, correlating with academic semesters was identified. IBD symptoms in the discovery cohort presented significantly more (P = 0.0218) during 5 months including the initiation (August, September, January) and the termination of academic semesters (December, May) compared to any other 5 months of the year. This observation was validated in the independent cohort (P < 0.0001). Our findings imply that academic stress may contribute to disease onset in pediatric IBD, which may improve timely diagnosis.
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