There are several factors which contribute to vitamin and mineral deficiencies in Inflammatory Bowel Disease (IBD).
The first is that due to inflammation in the small and/or large intestine, some nutrients are not fully absorbed. The use of vitamins and minerals in the body is complex, with many nutrients depending on others to facilitate the uptake and use by the body. If the body is not receiving even one nutrient it needs, the end result is a chain reaction affecting many other vitamins and minerals.
The second is due to the often-restricted diets that people with IBD follow to curb or prevent symptoms. Nausea, diarrhea, and vomiting make getting a balanced diet an almost impossible task.
The third is a result of treatment programs that often include many different types of medications. Some medications can inhibit the absorption of nutrients, or cause them to be lost from the body.
Vitamin DVitamin D is poorly absorbed by people with active inflammation in the small intestine caused by Crohn's disease, or who rely on corticosteroids such as prednisone. Necessary to help the body absorb calcium, vitamin D is found in fortified milk. However, those who are lactose intolerant (which includes many IBD patients) are unable to receive any vitamin D from this source. Vitamin D is also synthesized in the skin when it is exposed to sunlight. Just going out in the sun could provide some of this essential vitamin, but it is still poorly absorbed in the inflamed small intestine.
A severe deficiency of Vitamin D could lead to osteomalacia, or in the case of children, rickets. Literally, osteomalacia means "soft bones", and people with this condition are susceptible to bone fractures. The usual course of treatment is to supplement the diet with both calcium and vitamin D, and avoid the use of corticosteroids when possible. Therapy with other drugs may also be necessary, depending on the severity of bone density loss.
Vitamin D is found in:
- Butter and fortified margarines
- Eggs
- Fish liver oils
- Fortified milk and milk powder
- Liver
- Some fortified cereals
Zinc is lost in the stool; deficiencies can occur in people with IBD who have chronic diarrhea. Zinc has several important functions in body, including the transport of vitamin A, the healing of wounds and more than 80 enzyme actions. It can be found in meat, eggs, oysters, and whole grains.
Symptoms of zinc deficiency include slow healing, weakness, white flecks in fingernails, and impaired senses of sight, taste, and smell. Zinc deficiency can also cause a condition known as acrodermatitis enteropathica. Acrodermatitis enteropathica results in the inflammation of the skin on the elbows, knees, cheeks, mouth, and anus that may look like a rash. Zinc deficiency is often treated with supplements.
Zinc can be found in:
- Beef, lamb, pork, veal
- Chicken, turkey (dark meat)
- Liver, Heart
- Crab, lobster, oysters, shrimp
- Cheese (cheddar, American, gouda, mozzarella, muenster, Swiss)
- Legumes and lentils
- Bran
- Nuts
- Green peas
- Grains (wheat, rice, wheat germ and products made from these)
Check with your doctor or nutritionist about vitamin and mineral supplements if you are concerned about these, or any other, deficiencies.
