Various studies have emphasized a periodic trend in ulcer disease, with a higher incidence of relapse, complications, and painful symptoms in spring and autumn for duodenal ulcer (DU) and in winter for gastric ulcer (GU). It has been suggested that this seasonal trend may be linked with experimentally demonstrated year-round rhythmic changes in gastric acid output. This study retrospectively evaluated the seasonal nature of ulcer activity, symptoms, and complications in 293 endoscopically diagnosed patients (52 GU: 20 women, 32 men, mean age 56 years, range 22 to 82 years; 241 DU: 56 women, 185 men, mean age 51 years, range 21 to 87 years) with a mean follow-up of 20.3 months. Relapses occurred in 27% of the GU and 22% of the DU cases, and complications occurred in 6% of the GU and 12% of the DU cases. Clinical endoscopic check-ups were repeated every 6 to 12 months. A record was kept of alcohol and coffee intake, smoking habits, symptoms at time of diagnosis and check-up, endoscopic results, relapses, remission, and complications. Statistical analysis was made by Student's t test and the chi-square test. On diagnosis, 63% of patients reported a seasonal trend in symptoms (68% in the DU group and 44% in the GU group). During follow-up, painful symptoms occurred mainly in February, June-July, and October in DU cases whereas in GU cases the picture was more varied. Endoscopy revealed that in DU cases symptoms were closely related to activity, found mainly in February, May, and October. As for complications, no significant difference was found at different times of the year for either DU or GU cases. This study confirmed a thrice-yearly trend in DU (probably linked with the year-round rhythm demonstrated for basal acid outputs and maximal acid outputs), but no such seasonal trend for GU (although the low number of GU cases studied may influence this finding). These data may have useful therapeutic implications for a tailored seasonal maintenance therapy, thus ensuring better relapse prevention and avoiding unnecessary expense. Â© 1993 Excerpta Medica, Inc. All rights reserved.
Thrice-yearly rhythm of duodenal ulcer disease / Dotto, Paola; Farinati, Fabio; Battaglia, Giuseppe; Esmaillou, Abdolhossein; Vianello, Fabio; Libera, Gianni Della; Di Mario, Francesco. - In: CURRENT THERAPEUTIC RESEARCH-CLINICAL AND EXPERIMENTAL. - ISSN 0011-393X. - 53:6(1993), pp. 648-653. [10.1016/S0011-393X(05)80736-2]
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