Effects of temperature, weather, seasons, atmosphere, and climate on the exacerbation of inflammatory bowel diseases: A systematic review and meta-analysis

Abstract

Background Exacerbation of inflammatory bowel disease (IBD) is common. Identification of the exacerbating factors could facilitate interventions for forecastable environmental factors through adjustment of the patient’s daily routine. We assessed the effect of natural environmental factors on the exacerbation of IBD. Methods In this systematic review and meta-analysis, studies published from January 1, 1992 to November 3th, 2022 were searched in the MEDLINE, Embase, CINAHL Complete and Cochrane Library databases. We extracted data related to the impact of environmental variations on IBD exacerbation, and performed a meta-analysis of the individual studies’ correlation coefficient χ2 converted into Cramér’s V (φc) with 95% confidence intervals (CI). Results A total of 7,346 publications were searched, and 20 studies (sample size 248–84,000 cases) were selected. A meta-analysis with seven studies was performed, and the pooled estimate of the correlation (φc) between the seasonal variations and IBD exacerbations among 4806 cases of IBD exacerbation was 0.11 (95% CI 0.07–0.14; I2 = 39%; p = 0.13). When divided into subtypes of IBD, the pooled estimate of φc in ulcerative colitis (six studies, n = 2649) was 0.07 (95% CI 0.03–0.11; I2 = 3%; p = 0.40) and in Crohn’s disease (three studies, n = 1597) was 0.12 (95% CI 0.07–0.18; I2 = 18%; p = 0.30). Conclusion There was a significant correlation between IBD exacerbation and seasonal variations, however, it was difficult to synthesize pooled results of other environmental indicators due to the small number of studies and the various types of reported outcome measures. For clinical implications, additional evidence through well-designed follow-up studies is needed. Protocol registration number (PROSPERO) CRD42022304916.

Subjective Physical Symptoms Related to Bad Weather Among Persons Undergoing Medical Check-Up: A Single-Center Observational Study

“…Association between gastrointestinal problems and weather factors has not been reported in the general population till now, but a recent meta-analysis suggested the presence of seasonal variation in bowel symptoms among patients with inflammatory bowel disease [ 14 ]. Another recent study from Japan showed that the incidence of unexplained adhesive small bowel obstruction is susceptible to barometric pressure and humidity [ 15 ].…”

Uptake, safety, and effectiveness of inactivated influenza vaccine in patients with inflammatory bowel disease: a nationwide study in the UK using data from the Clinical Practice Research Datalink

“…As weather might exacerbate IBD 18 , season was a covariate of interest, defined in line with the Meteorological Office: spring (1 st March to 31 st May), summer (1 st June to 31 st August), autumn (1 st September to 30 th November) and winter (1 st December to 28 th February).…”

“…Safety As weather might exacerbate IBD 18 IIV effectiveness Mean (standard deviation (SD)), n (%) and standardised difference (d) were used to examine covariate balance between vaccinated and unvaccinated participants. PS for vaccination was calculated using logistic regression, treating vaccination status as the dependent variable.…”

The Impact of Climate Change on Immunity and Gut Microbiota in the Development of Disease

“…Moon and colleagues conducted a meta-analysis on 7346 publications and concluded that a noteworthy connection existed between exacerbations of IBD and seasonal fluctuations [ 124 ].…”

“…They showed that within the ulcerative colitis subgroup, there was a noticeable but weak correlation with seasonal variation, while within the Crohn’s disease subgroup, there was a weak positive correlation observed with exacerbations. Additionally, the studies indicated a notable positive correlation between air pollutants and exacerbations of IBD [ 124 ].…”