Racial disparities in readmission, complications, and procedures in children with Crohn's disease.
Inflamm Bowel Dis. 2015 Apr;21(4):801-8. doi: 10.1097/MIB.0000000000000325.
Dotson JL1, Kappelman MD, Chisolm DJ, Crandall WV.
- People with gut problems are low on vitamin D
- Intestinal absorption of vitamin D - a systematic review - Aug 2017
- Crohn’s Disease risk increased 3 X if inadequate vitamin D level (another form is needed) – Oct 2017
- Crohn's Disease relapse rate of 3 in 8 with 1,000 IU vs 0 in 12 with 10,000 IU of Vitamin D – RCT Feb 2017
- Crohn's Disease patients normalizing their Vitamin D levels decreased risk of surgery by 44 percent – Aug 2013
Overview Gut and vitamin D contains gut-friendly information
Getting Vitamin D into your body has the following chart
Getting Vitamin D into your body also has the following
If poorly functioning gut
Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into bloodstream
you can make your own sublinqual by dissovling Vitamin D in water or using nanoemulsion form
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into bloodstream. Prescription only?
Bio-Tech might be useful – it is also water soluble
Vitamin D sprayed inside cheeks 2X more response (poor gut) – RCT Oct 2015
and, those people with malabsorption problems had a larger response to spray
Inject Vitamin D quarterly into muscle, into vein, or perhaps into body cavity if quickly needed
Nanoparticles could be used to increase vitamin D getting to the gut – Oct 2015
Poor guts need different forms of vitamin D has the following
Guesses of Vitamin D response if poor gut
| Bio | Form | Speed | Duration |
| 10 | Injection ($$$) or Calcidiol or Calcitriol | D - Slow C -Fast | Long |
| 10 | Sun/UVB | Slow | Long |
| 10 | Topical (skin patch/cream, vagina) | Slow Fast nano | Normal |
| 9 | Nanoemulsion -mucosal perhaps activates VDR | Fast | Normal |
| 9? | Inhaled (future) | Fast | Normal |
| 8 | Bio-D-Mulsion Forte | Normal | Normal |
| 6 | Water soluble (Bio-Tech) | Normal | Normal |
| 4 | Sublingual/spray (some goes into gut) | Fast | Normal |
| 3 | Coconut oil based | Slow | Normal |
| 2 | Food (salmon etc.) | Slow | Normal |
| 2 | Olive oil based (majority) | Slow | Normal |
10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months
Overview Dark Skin and Vitamin D contains the following summary
FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D
More to Consider in The Battle Against Crohn's Amazon $29, 2016
Book has section on Crohn's and Vitamin D
# of ways in results (below) were added by VitaminDWiki
Download the PDF from VitaminDWiki
BACKGROUND:
Racial disparities in care and outcomes contribute to mortality and morbidity in children; however, the role in pediatric Crohn's disease is unclear. In this study, we compared cohorts of black and white children with Crohn's disease to determine the extent race is associated with differences in readmissions, complications, and procedures among hospitalizations in the United States.
METHODS:
Data were extracted from the Pediatric Health Information System (January 1, 2004-June 30, 2012) for patients with 21 years or younger hospitalized with a diagnosis of Crohn's disease. White and black cohorts were randomly selected in a 2:1 ratio by hospital. The primary outcome was time from index hospital discharge to readmission. The most frequent complications and procedures were evaluated by race.
RESULTS:
There were 4377 patients. Black children had a
- shorter time to first readmission and
- higher probability of readmission (P = 0.009) and a
- 16% increase in risk of readmission
compared with white children (P = 0.01). Black children had - longer length of stay and
- higher frequency of overall and
- late (30-d to 12-mo postdischarge) readmissions (P < 0.001).
- During index hospitalization, more black children had perianal disease and anemia (P < 0.001).
During any hospitalization, black children had - higher incidence of perianal disease,
- anemia, and
- vitamin D deficiency, [2.3% vs .9%] and
- greater number of perianal procedures,
- endoscopies, and
- blood product transfusion (P < 0.001).
CONCLUSIONS:
There are differences in hospital readmissions, complications, and procedures among hospitalized children related to race. It is unclear whether these differences are due to genetic differences, worse intrinsic disease, adherence, access to treatment, or treatment disparities.
Comment in
African Americans May Access the Emergency Department for Inflammatory Bowel Disease Care More Often than Whites.