Healthcare 2015, 3(2), 338-350; doi:10.3390/healthcare3020338 (registering DOI)
Aaron S. Bancil 1, andrew.poullis at stgeorges.nhs.uk and Andrew Poullis 2
1 Epsom Hospital, Dorking Road, Epsom, Surrey, KT18 7EG, UK
2 St George's Hospital, Blackshaw Road, London, SW17 0QT, UK
Received: 10 March 2015 / Accepted: 18 May 2015 / Published: 27 May 2015
(This article belongs to the Special Issue The Close Relationship: Health and Nutrition)
Vitamin D is known to be vital in maintaining bone health, mineralisation and for fracture prevention. It has also been implicated in a number of autoimmune diseases and has therefore been studied for its potential role in Inflammatory Bowel Disease (IBD). This review looks at the current literature on the role of vitamin D and its potential role as an immunomodulator, disease modifier and bone health in IBD patients. There is substantial supporting evidence of an important role from epidemiological, genetic and immunological studies, but there is also conflicting evidence and nothing proving to be definitive from clinical studies. There are also a number of confounders with IBD patients, as their lifestyles and medications may affect vitamin D levels. Murine studies have added vast amounts to our knowledge of vitamin D and its antimicrobial role, as well as its effect on immune cell proliferation other inflammatory molecules, such as Tumour Necrosis Factor-α (TNFα). It is clear that larger trials investigating the effects of oral supplementation of vitamin D in IBD patients are necessary.
Conclusions (clipped from PDF)
An increasing number of epidemiological, genetic, basic science and animal model studies support the concept that vitamin D regulation may partly determine occurrence and course of IBD, which warrants further study. Clinical studies have confirmed that vitamin D deficiency is common in this patient group. Data is starting to emerge that identifying those with a deficiency and correcting may improve health outcome measures.
There remain unanswered questions. It is yet unclear as to whether vitamin D deficiency is a causative factor for IBD or a risk factor and there is widespread variability of results amongst IBD patients. Thus more robust studies are required to elucidate whether there is a role for vitamin D in the management of IBD patients.
There also remain questions as to whether vitamin D modifies levels of inflammation, or its effect on disease severity. It is also not known whether vitamin D deficiency is associated with a clinical phenotype or its influence on risk of colorectal cancer in IBD patients .
It is clear that further studies are necessary to fully evaluate the role of vitamin D in IBD. Until the exact role of vitamin D in IBD is established it would seem sensible to identify and treat any IBD patients with a vitamin D deficiency.
Comment by VitaminDWiki:
Even if low vitamin D cannot be used to prevent IBD, a person with IBD should restore Vitamin D levels so as to provide some pain relief and prevent the occurance of other diseases associated with low vitamin D
- Overview Gut and vitamin D
- Vitamin D and Inflammatory Bowel Disease – review April 2015
- Inflammatory bowel disease – Vitamin D looks promising – Feb 2015
- Inflammatory bowel diseases treated with vitamin D – Review May 2014
- IBD more likely in areas with low UV ( and thus low vitamin D) – June 2014
- Inflammatory diseases: review of vitamin D, with many tables – May 2014