Background:

Over the last decade, it is estimated that Vitamin D insufficiency has increased. Currently, approximately 50% of the population has Vitamin D deficiency, including all ages and ethnicities (Nair, 2012). This change is thought to be partially due to behavior changes; such as less time spent outside, as well as an increase in the use of sunscreen while outside (Nair, 2012). Vitamin D insufficiency is defined as a serum vitamin D level between 21-29 ng/mL of 25-hydroxyvitamin D [25(OH)D] (Nair,2012). Vitamin D deficiency is defined as a serum vitamin D level

Purpose:

The purpose of this research is to determine if there is adequate Vitamin D status (25-hydroxyvitamin D [25(OH)D] >30 ng/mL) in patients with various gastrointestinal disorders; such as inflammatory bowel disease, liver disease, bowel resection, as well as those requiring parenteral nutrition following surgical resection or malabsorption issues. Low Vitamin D status may be a marker of increased risk for bone fractures, poor wound healing and other complications. A review of the literature will be conducted to summarize the evidence. This evidence will be used to educate providers, dietitians, diet technicians and dietetic interns on the importance of adequate Vitamin D status, and the connections to decline of health and function. The overall intent is to raise awareness of Vitamin D status and health outcomes in patients with GI disorders and the importance of adequate Vitamin D status.

Methods:

Literature was gathered by online library search using the PubMed database and Google Scholar. Using identified inclusion and exclusion criteria 26 studies were used and reviewed. The studies were then graded using the Academy of Nutrition and Dietetics Evidence Analysis Worksheet.

Results:

Patients with gastrointestinal disorders were at a higher risk of Vitamin D deficiency and should be monitored for Vitamin D status. Supplementing with oral Vitamin D alone or Vitamin D supplied in multivitamin form is recommended to maintain adequate Vitamin D status. Patients with Crohn’s disease were at higher risk for Vitamin D deficiency and should be monitored closely. Currently, IV Vitamin D is not available in the United States. Individuals relying solely on parenteral nutrition, are usually only receiving 400IU of vitamin D from the multivitamin provided within the parenteral infusion. UV light may be another option to be explored for those that cannot absorb vitamin D orally.

Conclusion:

1) Vitamin D status should be obtained in patients with Crohn’s disease, ulcerative colitis, short gut syndrome and other bowel resection surgeries, liver disease as well as those on parenteral nutrition with malabsorption disorders, to determine if deficiency or insufficiency is present. 2) Supplementation should be determined per protocol at each facility.