IBS – 82 percent had low vitamin D, 3,000 IU spray helped a lot – RCT Dec 2015

Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial

BMJ Open Gastro 2015; 2:e000052 doi:10.1136/bmjgast-2015-000052
Simon Tazzyman1, Nicholas Richards1, Andrew R Trueman1, Amy L Evans1, Vicky A Grant1, Iveta Garaiova2, Sue F Plummer2, Elizabeth A Williams3, Bernard M Corfe1
1Academic Unit of Surgical Oncology, Department of Oncology, University of Sheffield, Sheffield, UK
2Research Department, Cultech Ltd, Baglan Industrial Park, Port Talbot, UK
3Human Nutrition Unit, Department of Oncology, University of Sheffield, Sheffield, UK

Vitamin D levels for those who initially had < 20 ng

Background
Vitamin D deficiency has been associated or implicated with the pathophysiology of the gastrointestinal conditions inflammatory bowel disease and colorectal cancer, as well as with depression. No trials or epidemiology studies to date have investigated a link with irritable bowel syndrome (IBS). A single case report has suggested a benefit in IBS of vitamin D supplementation. We hypothesised that IBS participants with vitamin D insufficiency would benefit from repletion in terms of their IBS symptoms. We undertook a pilot trial to provide data to support a power calculation and to justify a full trial.

Methods
This was a randomised, double blinded, three-arm parallel design trial of vitamin D, placebo or a combination of vitamin D and probiotics. Participants were further stratified according to whether they were vitamin D replete or insufficient. Vitamin D status was determined by blood test at baseline and exit; IBS symptoms were assessed by validated questionnaire; dietary intakes were assessed by food frequency questionnaire.

Results
A significant proportion of the IBS population were vitamin D deficient, such that the replete stratum could not be adequately recruited. There was a significant association in the baseline data between circulating vitamin D level and quality of life (“How much has IBS affected your life?”). Supplementation significantly improved vitamin D level versus placebo. IBS symptoms were not significantly improved in this pilot, although a power calculation was enabled from the intervention data.

Conclusions
The IBS population exhibits significant levels of vitamin D insufficiency and would benefit from screening and possible supplementation. The impact of IBS on quality of life may be reduced by vitamin D level. Future trials should have a sample size of over 97.

Trial registration number: ICTRN 6116003917.

• “Study participants were recruited in the early months of 2014 ( January–April) with most follow-up visits taking place from May to August, most likely explaining the rise in 25OHD in all groups.”

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This study was reported on the web in many places - such as

• Large proportion of IBS sufferers are vitamin D deficient ScienceDaily Dec 2015
  "Researcher Vicky Grant has suffered with IBS for over 30 years. She reported a significant improvement in her symptoms following an introduction to a high-dose of vitamin D3 supplement approximately five years ago."
  "IBS is a chronic and debilitating functional disorder of the gastrointestinal (GI) tract which affects around 10-15 per cent of the western population."