Introduction Vitamin D plays a vital role in bone health, immune regulation and cancer prevention in inflammatory bowel disease (IBD). Our understanding has increased remarkably in the past decade, although the mechanism of its influence in IBD remains unclear as does its role in treatment. Although the efficacy of vitamin D as an immunomodulator remains to be established, given current evidence it appears reasonable to screen and treat vitamin D deficiency in patients with IBD.
Methods Two hundred consecutive patients with vitamin D deficiency were identified from IBD clinics at Leicester General Hospital who had been seen during a 12 month period. A postal questionnaire was sent to these patients. It was anonymous and requested whether: Respondents believed they had been told of their vitamin D deficiency. General practitioners had prescribed vitamin D supplements. Vitamin D supplements had been bought at local pharmacies. Brand of vitamin D supplements taken. Compliance with treatment. Symptoms had improved with treatment. They had enough sunlight exposure
Results Ninety eight of the 200 patients responded to the questionnaire, a reponse rate of 49%. Sixty five were English and 33 Asian. The response rate was 48% in Asians and 50% in English which is not significantly different. Seventy (71%) of the 98 patients, recalled being told they were vitamin D deficient. Thirty nine patients (40%) believed they had sufficient exposure to sunlight. 54 (71%) had been prescribed this medication by general practitioners and 22 (29%) had bought vitamin D supplements over the counter at local pharmacies or herbal stores. General practitioners predominantly prescribed Adcal D3 tablets. Sixty four (84%) patients said they were adherent to vitamin D treatment. Symptoms improved significantly in 29 (38%) patients. However, this figure rose to 45% when only those 64 patients who were compliant with therapy were considered.
Conclusion Vitamin D plays a significant role in intracellular functions which extends beyond its effects on bone metabolism. It is an important regulator of the immune system which may have implications for the development, severity and management of immune related disorders such as IBD. In summary the relationship between the vitamin D axis and IBD is multifaceted. It should comprise maintainence of musculoskeletal health and control of disease through immunomodulation and modification of associated malignancy.
Disclosure of Interest None Declared.
Vitamin D and inflammatory bowel disease – established concepts and future directions Alimentary Pharmacology and Therapeutics (2012) 36, 324–344 M.Garg, J.S.Lubel, M.P.Sparrow, S.G. Holt & P.R. Gibson 2. Vitamin D as a therapy for colitis A systematic review Journal of Crohns & Colitis (2012) 6, 405–411 I Nicholson, A. Mark Dalzell, Wael El-Matary.
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