People with new fecal incontinence are 1.9 X more likely to have low Vitamin D – Feb 2024

The association between vitamin-D deficiency and fecal incontinence

Neurogastroenterol Motil 2024 Feb 5:e14753. doi: 10.1111/nmo.14753 PDF can be viewed at DeepDyve
Leila Neshatian 1, Gabrielle Grant 2, Nielsen Fernandez-Becker 1, Ye Yuan 3, Patricia Garcia 1, Laren Becker 1, Brooke Gurland 4, George Triadafilopoulos 1

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Background: Vitamin-D is essential for musculoskeletal health. We aimed to determine whether patients with fecal incontinence (FI): (1) are more likely to have vitamin-D deficiency and, (2) have higher rates of comorbid medical conditions.

Methods: We examined 18- to 90-year-old subjects who had 25-hydroxy vitamin-D levels, and no vitamin-D supplementation within 3 months of testing, in a large, single-institutional electronic health records dataset, between 2017 and 2022. Cox proportional hazards survival analysis was used to assess association of vitamin-D deficiency on FI.

Key results: Of 100,111 unique individuals tested for serum 25-hydroxy vitamin-D, 1205 (1.2%) had an established diagnosis of FI. Most patients with FI were female (75.9% vs. 68.7%, p = 0.0255), Caucasian (66.3% vs. 52%, p = 0.0001), and older (64.2 vs. 53.8, p < 0.0001).

  • Smoking (6.56% vs. 2.64%, p = 0.0001) and
  • GI comorbidities, including
    • constipation (44.9% vs. 9.17%, p = 0.0001),
    • irritable bowel syndrome (20.91% vs. 3.72%, p = 0.0001), and
    • diarrhea (28.55% vs. 5.2%, p = 0.0001)

were more common among FI patients.
Charlson Comorbidity Index score was significantly higher in patients with FI (5.5 vs. 2.7, p < 0.0001). Significantly higher proportions of patients with FI had vitamin-D deficiency (7.14% vs. 4.45%, p < 0.0001). Moreover, after propensity-score matching, rate of new FI diagnosis was higher in patients with vitamin-D deficiency; HR 1.9 (95% CI [1.14-3.15]), p = 0.0131.

Conclusion & inferences: Patients with FI had higher rates of vitamin-D deficiency along with increased overall morbidity. Future research is needed to determine whether increased rate of FI in patients with vitamin-D deficiency is related to frailty associated with increased medical morbidities.

23 References
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VitaminDWiki – Overview Gut and vitamin D has

  • Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
  • Celiac disease has a strong genetic component.
    • Most, but not all, people with celiac disease have a gene variant.
    • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
    • Celiac disease causes poor absorption of nutrients such as vitamin D.
    • Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
    • The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
  • Review in Nov 2013 found that Vitamin D helped
    Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
  • All items in category gut and vitamin D 207 items

VitaminDWiki – Overview Gut and vitamin D contains gut-friendly information

Gut-friendly, Sublingual, injection, topical, UV, sunshine

Getting Vitamin D into your body has the following chart
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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 the bloodstream
Fat-soluble Vitamins go thru the slow lymph system
   you can make your own sublingual by dissolving Vitamin D in water or use nano form
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into the bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into the bloodstream. Prescription-only?
Bio-Tech might be useful – it is also water-soluble
Vitamin D sprayed inside cheeks (buccal spray) - several studies
    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 FormSpeedDuration
10Injection ($$$)
or Calcidiol or Calcitriol		D - Slow
C -Fast		Long
10 Sun/UVBSlowLong
10Topical
(skin patch/cream, vagina)		Slow
Fast nano		Normal
9Nanoemulsion -mucosal
perhaps activates VDR		FastNormal
9?Inhaled (future)FastNormal
8Bio-D-Mulsion ForteNormalNormal
6Water soluble (Bio-Tech)NormalNormal
4Sublingual/spray
(some goes into gut)		FastNormal
3Coconut oil basedSlowNormal
2Food (salmon etc.)SlowNormal
2Olive oil based (majority)SlowNormal

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

VitaminDWiki – Gut category listing contains

207 items in GUT category - see also Overview Gut and vitamin D, See also Microbiome category listing has 38 items along with related searches.

VitaminDWiki – Irritable Bowel Syndrome and Vitamin D - many studies

VitaminDWiki – Constipation - Magnesium, Calcium and cofactors

Note: Vitamin D both consumes Magnesium and Increases Calcium

VitaminDWiki – Smoking reduces vitamin D - many studies

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