Seasonal patterns of hospital treatment for inflammatory bowel disease in Italy.

AIM: It is still debated whether clinical flare-ups of chronic inflammatory bowel disease follow a seasonal pattern, and the various reports are based on general practitioners' records or hospital discharge charts. There are, however, no specific figures for treatment in hospital gastroenterology units, which serve as a reference point for these disorders. This study was therefore designed to investigate whether there is a seasonal pattern in admissions for inflammatory intestinal disease in Italy, differing from what is generally known about gastrointestinal pathologies, since there are no nation-wide figures on the subject. METHODS: The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 22 centers in Italy. RESULTS: From winter 2000 to autumn 2003, the 22 gastroenterology units participating in the RING project discharged 32,357 patients following ordinary hospital admissions. Of these, 2,856 (8.8%) had a main diagnosis of inflammatory bowel disease: 1,541 Crohn's disease, and 1,315 ulcerative colitis. No seasonal patterns were detected for either category, or when the analysis was done by age, sex and site of disease. CONCLUSIONS: The most serious flare-ups of inflammatory bowel disease, i.e. those requiring routine hospital treatment, do not appear to follow any seasonal pattern, regardless of the site of the disease or the patient's age or sex.

[Esophageal function remains unchanged in systemic sclerosis at four years of follow-up]. / La funzionalità esofagea rimane inalterata nella sclerosi sistematica ad un follow-up di 4 anni.

AIM: Esophageal involvement is one of the earliest gastrointestinal manifestations of systemic sclerosis. Reduced lower esophageal sphincter pressure and reduced esophageal motility can both be measured by manometry. METHODS: 15 patients with systemic sclerosis (6 with altered manometric values and 9 with symptoms of pyrosis and/or dysphagia but with normal manometric values) were reassessed after a follow-up period of over 46 months. RESULTS: Low though still within normal range values in lower esophageal pressure were found on manometry. Distal esophageal amplitude remained substantially unchanged. Only in one patient was the amplitude significantly reduced. In all patients, the symptom scores for pyrosis and dysphagia had worsened slightly. CONCLUSIONS: Esophageal involvement does not necessarily occur in all patients with systemic sclerosis; more time may be required before its manifestations can be assessed by esophageal manometry.