Managing vitamin D deficiency in inflammatory bowel disease

TY - JOUR

T1 - Managing vitamin D deficiency in inflammatory bowel disease

AU - Nielsen, Ole Haagen

AU - Hansen, Thomas Irgens

AU - Gubatan, John Mark

AU - Jensen, Kim Bak

AU - Rejnmark, Lars

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - biologics

KW - clinical control

KW - inflammatory bowel disease

KW - therapy

KW - vitamin D

U2 - 10.1136/flgastro-2018-101055

DO - 10.1136/flgastro-2018-101055

M3 - Review

C2 - 31656565

AN - SCOPUS:85059769416

SN - 2041-4137

SP - 1

EP - 7

JO - Frontline Gastroenterology

JF - Frontline Gastroenterology

ER -