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Inflammatory bowel diseases are helped by vitamin D – commissioned review Nov 2013

Review article: vitamin D and inflammatory bowel diseases

Alimentary Pharmacology & Therapeutics Article first published online: 17 NOV 2013. DOI: 10.1111/apt.12553
V. P. Mouli 1,
A. N. Ananthakrishnan 2,3,*
1 Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
2 Harvard Medical School, Boston, MA, USA
3 Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
* Correspondence to: Dr A. N. Ananthakrishnan, Crohn's & Colitis Centre, Massachusetts General Hospital, 165 Cambridge Street, 9th Floor, Boston, MA 02114, USA. aananthakrishnan at partners.org
This commissioned review article was subject to full peer review and the authors received an honorarium from Wiley on behalf of AP&T.

Background: Vitamin D is traditionally associated with bone metabolism.
The immunological effects of vitamin D have increasingly come into focus.

Aims: To review the evidence supporting a role of vitamin D in inflammatory bowel diseases.

Methods: A comprehensive search was performed on PubMed using the terms ‘crohn's disease’ ‘ulcerative colitis’ and ‘vitamin D’.

Results: Vitamin D deficiency is common in patients with inflammatory bowel diseases (IBD) (16–95%) including those with recently diagnosed disease. Evidence supports immunological role of vitamin D in IBD. In animal models, deficiency of vitamin D increases susceptibility to dextran sodium sulphate colitis, while 1,25(OH)2D3 ameliorates such colitis. One prospective cohort study found low predicted vitamin D levels to be associated with an increased risk of Crohn's disease (CD). Limited data also suggest an association between low vitamin D levels and increased disease activity, particularly in CD. In a large cohort, vitamin D deficiency (<20 ng/mL) was associated with increased risk of surgery (OR 1.8, 95% CI 1.2–2.5) in CD and hospitalisations in both CD (OR 2.1, 95% CI 1.6–2.7) and UC (OR 2.3, 95% CI 1.7–3.1). A single randomised controlled trial demonstrated that vitamin D supplementation may be associated with reduced frequency of relapses in patients with CD compared with placebo (13% vs. 29%, P = 0.06).

Conclusions: There is growing epidemiological evidence to suggest a role for vitamin D deficiency in the development of IBD and also its influence on disease severity. The possible therapeutic role of vitamin D in patients with IBD merits continued investigation.

Clipped from PDF



Intervention: Crohn's and Ulcerative colitis


Table 4 | Unanswered clinical questions regarding the role of vitamin D in inflammatory bowel diseases

  1. Does low serum vitamin D cause Crohn's disease or ulcerative colitis, or is it a marker for other risk factors?
  2. . Can supplementation with vitamin D in high-risk individuals prevent or delay the onset of Crohn's disease or ulcerative colitis?
  3. Does vitamin D deficiency cause a more severe phenotype or increased inflammatory activity in Crohn's disease,
    or is it merely a consequence of severity of disease?
    Is vitamin D status predictive of recurrence of Crohn's disease post-operatively?
  4. What is the optimal role of vitamin D supplementation as a therapeutic modality in patients with IBD?
    Induction of remission?
    Maintenance of remission and prevention of relapse?
    Prevention of post-operative recurrence?
  5. What is the optimal serum 25(OH)D level for its effect on inflammation in patients with IBD?
  6. What is the optimal dose and modality for treatment of vitamin D deficiency in IBD patients?
  7. Can vitamin D supplementation reduce risk of colorectal cancer in IBD?

PDF is attached at the bottom of this page

See also VitaminDWiki

Possible Vitamin D Interactions

Attached files

ID Name Comment Uploaded Size Downloads
3294 CD and UC intervention.jpg admin 18 Nov, 2013 93.84 Kb 10256
3293 IBD.jpg admin 18 Nov, 2013 243.36 Kb 3275
3292 IBD.pdf admin 18 Nov, 2013 229.13 Kb 1172