Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases

Krishna MZ1, Barton KR1, Perez CM1, Walsh SM1, Assa A2, Kellermayer R1,3. J Pediatr Gastroenterol Nutr. 2018 May 30. doi: 10.1097/MPG.0000000000002032. [Epub ahead of print]

Author information

1 Section of Pediatric Gastroenterology, Baylor College of Medicine.

2 Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

3 USDA/ARS Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX.


It is currently unclear whether seasonality affects the onset of inflammatory bowel diseases (IBDs: Crohn's disease and ulcerative colitis) in children. Here, we examined the records of pediatric IBD patients 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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