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P769 Seasonal variations in acute hospital admissions with inflammatory bowel disease

A. Yadav*1, E. Kelly1, P. R. Armstrong1, M. N. Fauzi1, C. McGarry1, C. Shaw1, B. Hall1, O. Kelly1, C. Smyth1, R. J. Farrell1

1Connolly Hospital and RCSI, Blanchardstown, Dublin 15, Department of Gastroenterology, Dublin, Ireland

Background

Several environmental factors have been reported to play a significant role in both the aetiology and exacerbation of inflammatory bowel disease (IBD). However, there is scarce and conflicting data assessing the role of seasonal variations on exacerbations of IBD. The aim of this study was to determine the relationship between seasonal variation and hospital admissions with IBD, and correlation between environmental factors (temperature and rainfall) and acute hospital admissions for IBD.

Methods

This single-centre retrospective cohort study included patients admitted acutely to our hospital with Crohn’s disease (CD) or Ulcerative colitis (UC) between September 1st 2015 and August 31st 2018. Patient data were collected from Hospital In-Patients Enquiry (HIPE) system and temperature and rainfall data were accessed from the MET Èireann website.

Results

A total of 227 patients were included in the study. CD: 142 (M: 65, F: 77, Mean age: 42 ± 14.9 years), UC: 85 (M: 35, F: 50, Mean age: 51 ± 21 years). There were significantly more CD admissions in summer and spring (44, 44) compared with autumn and winter (28, 26), (p = 0.04 chi-square). By contrast, while there were low numbers of UC admissions in the summer (16) there was no significant seasonal variation when compared with spring (26), autumn (21) or winter (22); (p = 0.49). There was a significant negative correlation between CD admissions and mean monthly rainfall (p-value: 0.02) and a significant negative correlation between UC admissions and mean monthly temperature (p-value: 0.04). There was no significant correlation observed between temperature and CD admissions or between rainfall and UC admissions.

Conclusion

Our data indicate a high incidence of CD admissions in spring and summer with a low incidence of UC admissions in summer. Seasonal changes as well as changes in temperature and rainfall appear to have a dichotomous relationship with CD and UC. Seasonal factors may be responsible for triggering IBD exacerbations in addition to other environmental factors such as infections, smoking, NSAIDs and use of other medications.