title: Life-event stress induced by the Great East Japan Earthquake was associated with relapse in ulcerative colitis but not Crohn's disease: a retrospective cohort study.
abstract: OBJECTIVE
  Stress is thought to be one of the triggers of relapses in patients with inflammatory bowel disease (IBD). We examined the rate of relapse in IBD patients before and after the Great East Japan Earthquake.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  13 hospitals in Japan.
  
  
  METHODS
  546 ulcerative colitis (UC) and 357 Crohn's disease (CD) patients who received outpatient and inpatient care at 13 hospitals located in the area that were seriously damaged by the earthquake. Data on patient's clinical characteristics, disease activity and deleterious effects of the earthquake were obtained from questionnaires and hospital records.
  
  
  METHODS
  We evaluated the relapse rate (from inactive to active) across two consecutive months before and two consecutive months after the earthquake. In this study, we defined 'active' as conditions with a partial Mayo score=2 or more (UC) or a Harvey-Bradshaw index=6 or more (CD).
  
  
  RESULTS
  Among the UC patients, disease was active in 167 patients and inactive in 379 patients before the earthquake. After the earthquake, the activity scores increased significantly (p<0.0001). A total of 86 patients relapsed (relapse rate=15.8%). The relapse rate was about twice that of the corresponding period in the previous year. Among the CD patients, 86 patients had active disease and 271 had inactive disease before the earthquake. After the earthquake, the activity indices changed little. A total of 25 patients experienced a relapse (relapse rate=7%). The relapse rate did not differ from that of the corresponding period in the previous year. Multivariate analyses revealed that UC, changes in dietary oral intake and anxiety about family finances were associated with the relapse.
  
  
  CONCLUSIONS
  Life-event stress induced by the Great East Japan Earthquake was associated with relapse in UC but not CD.
authors: Division of Gastroenterology,  Tohoku University Graduate School of Medicine, Sendai,  Japan.
authors: Hisashi
authors: H
authors: Shiga
authors: Teruko
authors: T
authors: Miyazawa
authors: Yoshitaka
authors: Y
authors: Kinouchi
authors: Seiichi
authors: S
authors: Takahashi
authors: Gen
authors: G
authors: Tominaga
authors: Hiroki
authors: H
authors: Takahashi
authors: Sho
authors: S
authors: Takagi
authors: Nobuya
authors: N
authors: Obana
authors: Tatsuya
authors: T
authors: Kikuchi
authors: Shinya
authors: S
authors: Oomori
authors: Eiki
authors: E
authors: Nomura
authors: Manabu
authors: M
authors: Shiraki
authors: Yuichirou
authors: Y
authors: Sato
authors: Shuichiro
authors: S
authors: Takahashi
authors: Ken
authors: K
authors: Umemura
authors: Hiroshi
authors: H
authors: Yokoyama
authors: Katsuya
authors: K
authors: Endo
authors: Yoichi
authors: Y
authors: Kakuta
authors: Hiroki
authors: H
authors: Aizawa
authors: Masaki
authors: M
authors: Matsuura
authors: Tomoya
authors: T
authors: Kimura
authors: Masatake
authors: M
authors: Kuroha
authors: Tooru
authors: T
authors: Shimosegawa
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