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Small bowel and Nutrition
Review
Managing vitamin D deficiency in inflammatory bowel disease
  1. Ole Haagen Nielsen1,
  2. Thomas Irgens Hansen1,
  3. John Mark Gubatan2,
  4. Kim Bak Jensen3,4,
  5. Lars Rejnmark5
  1. 1 Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
  2. 2 Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA
  3. 3 Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
  4. 4 Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Stem Cell Research, University of Copenhagen, Copenhagen, Denmark
  5. 5 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Professor Ole Haagen Nielsen, Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Copenhagen 2730, Denmark; ohn{at}dadlnet.dk

Abstract

Management of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is generally cumbersome for patients and is a massive health-economic burden. In recent years, the immunomodulating effects of vitamin D have gained a huge interest in its possible pathogenic influence on the pathophysiology of IBD. Vitamin D deficiency is frequent among patients with IBD. Several clinical studies have pointed to a critical role for vitamin D in ameliorating disease outcomes. Although causation versus correlation unfortunately remains an overwhelming issue in the illusive chicken versus egg debate regarding vitamin D and IBD, here we summarise the latest knowledge of the immunological effects of vitamin D in IBD and recommend from available evidence that physicians regularly monitor serum 25(OH)D levels in patients with IBD. Moreover, we propose an algorithm for optimising vitamin D status in patients with IBD in clinical practice. Awaiting well-powered controlled clinical trials, we consider vitamin D supplementation to be an affordable and widely accessible therapeutic strategy to ameliorate IBD clinical outcomes.

  • biologics
  • clinical control
  • inflammatory bowel disease
  • therapy
  • vitamin D

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/flgastro-2018-101055

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    Footnotes

    • Contributors The authors’ responsibilities were as follows: OHN wrote first draft of the manuscript; TIH, JMG, KBJ and LR subsequently added and revised the manuscript. All authors read and approved the final manuscript. None of the authors reported a conflict of interest related to the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.