Screening and Treatment of Vitamin D Deficiency in UK Patients with Crohn’s Disease: Self-Reported Practice among Gastroenterologists

Fletcher, Jane; Swift, Amelia; Hewison, Martin; Cooper, Sheldon C.

doi:10.3390/nu12041064

Cited by 4 publications

(4 citation statements)

References 32 publications

(43 reference statements)

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“…In terms of treatment for vitamin D deficiency, nurse prescribers may take the lead in prescribing vitamin D supplements. Our previous work identified some inconsistencies in this area of practice amongst Gastroenterologists, partly due to a lack of clear national guidance (Fletcher et al, 2020). Therefore, nurse prescribing of vitamin D supplementation is likely to be guided by local policies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of vitamin D deficiency and modifiable risk factors in patients with Crohn's disease: A prospective observational study

Fletcher

Brown

Hewison

et al. 2022

Journal of Advanced Nursing

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Aims:To determine the prevalence of vitamin D deficiency in adults with Crohn's Disease (CD) in Birmingham, UK (latitude 52.4°N, −1.9°E) and identify modifiable risk factors.Design/Method: A nurse-led, single-centre, prospective study was conducted over 5 months in 2019 and 2020 in outpatients with CD, at a tertiary referral hospital in Birmingham UK. Vitamin D (25OHD) levels were measured at a single timepoint by a dried blood spot sample. Modifiable risk factor data were collected including intake of vitamin D-containing foods, use of vitamin D supplements, sun exposure and current smoking.Results: Total 150 participants (53.3% male, 79.3% white British). Vitamin D deficiency (25OHD <50 nmol/L) was found in 53.3%. 32.7% of participants took overthe-counter vitamin D supplements and 20.7% used prescribed supplements. We found that diets were generally poor in relation to vitamin D-rich foods. In terms of sun exposure, few (18%) had visited a sunny country recently, and few (6%) covered their whole body with clothing. Most used High Sun Protection Factor (80%) with a median grade of SPF 45. Conclusion:Patients with CD are at high risk of vitamin D deficiency as defined by 25OHD < 50 nmol/L, with the prevalence of deficiency being highest during the winter months. Patients with CD in the UK are unlikely to maintain vitamin D levels from sunlight exposure, dietary sources or over-the-counter supplements. Impact:• Patients with Crohn's Disease are at high risk of developing vitamin D deficiency but there is little data from the UK at this latitude.• We demonstrate the prevalence and severity of vitamin D deficiency in people with Crohn's Disease in the UK.• The prevalence of vitamin D deficiency in this group is high and warrants monitoring by nurses and clinical teams. Nurses and clinical teams should consider strategies for vitamin D supplementation in patients with Crohn's Disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence of vitamin D deficiency and modifiable risk factors in patients with Crohn's disease: A prospective observational study

Fletcher

Brown

Hewison

et al. 2022

Journal of Advanced Nursing

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“…Despite this, some experts suggest VD supplementation in IBD patients. Some information regarding the best dose of VD in IBD patients can be derived from the study by Goulart et al [ 103 ]. Pooling the data collected with nine RCTs, they calculated that improvement of clinical score and patient quality of life were associated with 25(OH)D serum concentrations >20 ng/mL, and relapse could be avoided with 25(OH)D levels above 40 ng/mL.…”

Section: Vitamin D and Inflammatory Bowel Diseasementioning

confidence: 99%

“…The American Gastroenterological Association (AGA) suggests vitamin D and calcium supplementation, particularly in patients at high risk of osteoporosis. Finally, the British Society of Gastroenterology, ECCO, and AGA guidelines regarding osteoporosis in IBD do not advocate routine measurement of serum vitamin D levels [ 103 ].…”

Section: Vitamin D and Inflammatory Bowel Diseasementioning

confidence: 99%

Role of Vitamin D in Celiac Disease and Inflammatory Bowel Diseases

et al. 2022

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Vitamin D (VD) is a pro-hormone that has long been known as a key regulator of calcium homeostasis and bone health in both children and adults. In recent years, studies have shown that VD may exert many extra-skeletal functions, mainly through a relevant modulation of the innate and adaptive immune system. This has suggested that VD could play a fundamental role in conditioning development, clinical course, and treatment of several autoimmune disorders, including celiac disease (CD) and inflammatory bowel diseases (IBDs). The main aim of this review is to evaluate the relationships between VD, CD, and IBDs. Literature analysis showed a potential impact of VD on CD and IBDs can be reasonably assumed based on the well-documented in vitro and in vivo VD activities on the gastrointestinal tract and the immune system. The evidence that VD can preserve intestinal mucosa from chemical and immunological damage and that VD modulation of the immune system functions can contrast the mechanisms that lead to the intestinal modifications characteristic of gastrointestinal autoimmune diseases has suggested that VD could play a role in controlling both the development and the course of CD and IBDs. Administration of VD in already diagnosed CD and IBD cases has not always significantly modified disease course. However, despite these relevant problems, most of the experts recommend monitoring of VD levels in patients with CD and IBDs and administration of supplements in patients with hypovitaminosis.

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“…The detection of serum 25(OH)D levels should be a basic component of IBD management. At present, there is no consensus on the level of serum 25(OH)D that should be maintained for IBD patients ( 116 ). The main circulating form of vitamin D, 25(OH)D, mainly exists in the form of combining with protein, and a few exist in the form of free ( 117 ).…”

Section: Nutraceuticals For the Treatment Of Ibdmentioning

confidence: 99%

Nutraceuticals for the Treatment of IBD: Current Progress and Future Directions

et al. 2022

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Inflammatory bowel disease (IBD) is a chronic relapsing-remitting inflammatory disease of the gastrointestinal tract. Patients are usually diagnosed in adolescence and early adulthood and need lifelong treatment. In recent years, it has been found that diet plays an important role in the pathogenesis of IBD. Diet can change intestinal barrier function, affect the structure and function of intestinal flora, and promote immune disorder, thus promoting inflammation. Many patients believe that diet plays a role in the onset and treatment of the disease and changes their diet spontaneously. This review provides some insights into how nutraceuticals regulate intestinal immune homeostasis and improve intestinal barrier function. We reviewed the research results of dietary fiber, polyphenols, bioactive peptides, and other nutraceuticals in the prevention and treatment of IBD and sought better alternative or supplementary treatment methods for IBD patients.

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Screening and Treatment of Vitamin D Deficiency in UK Patients with Crohn’s Disease: Self-Reported Practice among Gastroenterologists

Cited by 4 publications

References 32 publications

Prevalence of vitamin D deficiency and modifiable risk factors in patients with Crohn's disease: A prospective observational study

Prevalence of vitamin D deficiency and modifiable risk factors in patients with Crohn's disease: A prospective observational study

Role of Vitamin D in Celiac Disease and Inflammatory Bowel Diseases

Nutraceuticals for the Treatment of IBD: Current Progress and Future Directions

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