Vitamin D in pediatric gastrointestinal disease

• Published in: Current opinion in pediatrics Vol. 29; no. 1; p. 122
• Main Authors: Ahlawat, Rajni, Weinstein, Toba, Pettei, Michael J
• Format: Journal Article
• Language: English
• Published: United States 01.02.2017
• Subjects: Celiac Disease - complications; Child; Humans; Inflammatory Bowel Diseases - complications; Prevalence; Vitamin D Deficiency - complications; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - epidemiology; Vitamin D Deficiency - therapy
• ISSN: 1531-698X
• DOI: 10.1097/MOP.0000000000000451

The purpose of this review is to examine the prevalence of vitamin D deficiency in pediatric gastrointestinal disease, specifically celiac disease and inflammatory bowel disease (IBD); to discuss the role of vitamin D and its deficiency in gastrointestinal disease pathophysiology; and to present current literature regarding diagnosis and treatment of vitamin D deficiency in these pediatric gastrointestinal diseases. Vitamin D deficiency is common in children with gastrointestinal symptoms and disease processes. In celiac disease, vitamin D status should be routinely assessed at the time of diagnosis and during subsequent follow up if deficient. There is growing evidence to suggest an inverse association between vitamin D and IBD activity; however, the therapeutic role of vitamin D in IBD patients requires further investigation. Suboptimal vitamin D status commonly occurs in children with gastrointestinal disease. It is advisable to check serum 25-hydroxy vitamin D levels in children with newly diagnosed celiac disease and IBD. In celiac disease, vitamin D status should be assessed during subsequent follow up if deficient. In IBD, 25-hydroxy vitamin D levels should be checked at least yearly. Therapy should be provided to maintain a level of greater than 30 ng/ml but less than 100 ng/ml; however, the ideal vitamin D dosing regimen to treat vitamin D deficiency and to maintain this optimum level remains unknown. The role of vitamin D as a therapeutic agent in IBD is still under investigation.