Inflammatory bowel disease is a general term to describe recurring inflammation of the small or large intestine. Inflammation often leads to ulceration and eventually scar tissue can form. This includes Crohn’s disease (where it affects the small intestine) and ulcerative colitis (where it affects the large intestine.
Patients with inflammatory bowel disease are often deficient in many nutrients. They commonly have problems absorbing nutrients, have poor appetites, are often on restrictive diets, or are nutrient deficient as a result of drug therapy. According to a review of research appearing in the Annual Review of Nutrition (1985;5:463-484), nutritional deficiencies are common in patients hospitalized with inflammatory bowel disease. Iron deficiency was found in 40% of the patients, 48% were deficient in vitamin B12, between 54 and 64% were deficient in folate, between 14 and 33% were magnesium deficient, between 6% and 14% had a potassium deficiency, 21% were deficient in vitamin A, 12% were deficient in vitamin C, between 25% and 65% were deficient in 25-hydroxyvitamin D and between 40% and 50% had a zinc deficiency. Other vitamin deficiencies included vitamin K, copper and vitamin E.
According to a study of 114 patients with inflammatory bowel disease, appearing in the Scandinavian Journal of Gastroenterology (1979;14:1019-1024) found low serum folate in 59% of patients with chronic inflammatory bowel disease. There is an increased risk for colorectal cancer in patients with inflammatory bowel disease. Research appearing Inflammatory Bowel Diseases (2008 Feb;14(2):242-8), folic acid deficiency was associated with an increased risk of colorectal cancer. Patients who had inflammatory bowel disease and both a folic acid deficiency and high homocysteine had 17 times as many cancerous lesions as patients who were not folic acid deficient.
Some of the vitamin deficiencies may contribute to the severity of the disease. The disease creates vitamin deficiency, which in turn makes the disease more severe. A study involving 30 male and 31 female patients with inflammatory bowel disease was published in the American Journal of Gastroenterology (2003;98(1):112-117). It found that vitamin B6 levels were significantly lower in patients with inflammatory bowel disease than they were in healthy controls. Furthermore, vitamin B6 levels were lower in patients who were experiencing a flare up in their symptoms than they were for patients in remission. Low vitamin B6 levels were also associated with higher levels of what are known as inflammatory markers (these are chemicals that, when present, indicate inflammation) C-reactive protein is an example of an inflammatory marker; it was increased in patients with low B6 levels.
Vitamin supplementation for patients with inflammatory bowel disease is sometimes a problem. For some patients, taking vitamin pills can exacerbate the condition. There are liquid vitamins that may be better tolerated (folic acid is not stable in a liquid multiple vitamin and should be given separately; several companies make a liquid folic acid supplement). Sometimes giving vitamins intravenously is a solution.