Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?

Abstract

Background

Low vitamin D status is associated with risk of colorectal cancer and has been implicated in inflammatory bowel disease. Irritable bowel syndrome (IBS) is a chronic, relapsing, functional bowel disorder. A nascent literature suggests a role for vitamin D in IBS, but this has not been collated or critiqued. To date, seven studies have been published: four observational studies and three randomised controlled trials (RCTs). All observational studies reported that a substantial proportion of the IBS population was vitamin D deficient. Two intervention studies reported improvement in IBS symptom severity scores and quality of life (QoL) with vitamin D supplementation.

There are limited data around the role of vitamin D in IBS.

Conclusions

The available evidence suggests that low vitamin D status is common among the IBS population and merits assessment and rectification for general health reasons alone. An inverse correlation between serum vitamin D and IBS symptom severity is suggested and vitamin D interventions may benefit symptoms. However, the available RCTs do not provide strong, generalisable evidence; larger and adequately powered interventions are needed to establish a case for therapeutic application of vitamin D in IBS.

This is a preview of subscription content

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    Kulie T, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009;22:698.

    Article  Google Scholar 

  2. 2.

    Fraser DR. Vitamin D. Lancet. 1995;345:104–7.

    CAS  Article  Google Scholar 

  3. 3.

    Holick MF, Holick MF. Vitamin D [electronic resource]: physiology, molecular biology, and clinical applications. 2nd ed. Totowa, NJ: Humana; 2010.

  4. 4.

    Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. Obstet. 2011;66:356–7.

    Google Scholar 

  5. 5.

    Khayyat Y, Attar S. Vitamin D deficiency in patients with irritable bowel syndrome: does it exist? Oman Med J. 2015;30:115.

    Article  Google Scholar 

  6. 6.

    Nwosu BU, Maranda L, Candela N. Vitamin D status in pediatric irritable bowel syndrome. PLoS ONE. 2017;12:e0172183.

    Article  Google Scholar 

  7. 7.

    NICE. Vitamin D: increasing supplement use in at-risk groups. London, UK: NICE; 2014. https://www.nice.org.uk/guidance/ph56

  8. 8.

    Buttriss JL. Vitamin D: sunshine vs. diet vs. pills. Nutr Bull. 2015;40:279–85.

    Article  Google Scholar 

  9. 9.

    Del Pinto R, Pietropaoli D, Chandar A, Ferri C, Cominelli F. Association between inflammatory bowel disease and vitamin D deficiency: a systematic review and meta-analysis. Dig Liver Dis. 2016;48:E161.

    Article  Google Scholar 

  10. 10.

    Zhang X, Giovannucci E. Calcium, vitamin D and colorectal cancer chemoprevention. Best Pract. 2011;25:485–94.

    CAS  Article  Google Scholar 

  11. 11.

    Touvier M, Chan DS, Lau R, Aune D, Vieira R, Greenwood DC, et al. Meta-analyses of vitamin D intake, 25-hydroxyvitamin D status, vitamin D receptor polymorphisms, and colorectal cancer risk. Cancer Epidemiology, Biomarkers & Prevention. 2011;20:1003–1016.

    CAS  Article  Google Scholar 

  12. 12.

    Dulai PS, Singh S, Marquez E, Khera R, Prokop LJ, Limburg PJ, et al. Chemoprevention of colorectal cancer in individuals with previous colorectal neoplasia: systematic review and network meta-analysis. BMJ 2016;355.

  13. 13.

    Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480–91.

    Article  Google Scholar 

  14. 14.

    Soubieres A, Wilson P, Poullis A, Wilkins J, Rance M. Burden of irritable bowel syndrome in an increasingly cost-aware National Health Service. Frontline Gastroenterol. 2015;6:246.

    Article  Google Scholar 

  15. 15.

    Lee B, Bak Y. Irritable bowel syndrome, gut microbiota and probiotics. J Neurogastroenterol Motil 2011;17:252–66.

    Article  Google Scholar 

  16. 16.

    Boersma K, Ljótsson B, Edebol-Carlman H, Schrooten M, Linton SJ, Brummer RJ. Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects. Cogn Behav Ther. 2016;45:415–30.

    Article  Google Scholar 

  17. 17.

    Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther J. 2014;40:1023–34.

    CAS  Article  Google Scholar 

  18. 18.

    Wilkins T, Pepitone C, Alex B, Schade RR. Diagnosis and management of IBS in adults. Am Fam Physician. 2012;86:419.

    PubMed  Google Scholar 

  19. 19.

    Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377–90.

    Article  Google Scholar 

  20. 20.

    Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel. Br Med J. 1978;2:653.

    CAS  Article  Google Scholar 

  21. 21.

    Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA. The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology. 2000;119:654–60.

    CAS  Article  Google Scholar 

  22. 22.

    Sprake EF, Grant VA, Corfe BM. Vitamin D3 as a novel treatment for irritable bowel syndrome: single case leads to critical analysis of patient-centred data. BMJ Case Rep. 2012;2012.

  23. 23.

    Abbasnezhad A, Amani R, Hajiani E, Alavinejad P, Cheraghian B, Ghadiri A. Effect of vitamin D on gastrointestinal symptoms and health-related quality of life in irritable bowel syndrome patients: a randomized double-blind clinical trial. Neurogastroenterol Motil. 2016;28:1533–44.

    CAS  Article  Google Scholar 

  24. 24.

    Jalili M, Hekmatdoost A, Vahedi H, Poustchi H, Khademi B, Saadi M, et al. Co-Administration of soy isoflavones and vitamin D in management of irritable bowel disease. PLoS ONE. 2016;11.

    Article  Google Scholar 

  25. 25.

    Tazzyman S, Richards N, Trueman AR, Evans AL, Grant VA, Garaiova I, et al. Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: outcomes from a pilot trial. BMJ Open Gastroenterol. 2015;2:e000052.

    Article  Google Scholar 

  26. 26.

    Al-Ajlan AS. Screening of coeliac disease in undetected adults and patients diagnosed with irritable bowel syndrome in Riyadh, Saudi Arabia. Saudi J Biol Sci. 2016;23:462–6.

    Article  Google Scholar 

  27. 27.

    Al-Daghri NM. Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. J Steroid Biochem Mol Biol. 2016;175:102–7.

    CAS  Article  Google Scholar 

  28. 28.

    Yarandi S, Christie J. The prevalence of vitamin D deficiency in patients with irritable bowel syndrome. Am J Gastroenterol. 2013;108:S565.

    Google Scholar 

  29. 29.

    Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol. 1997;11:395–402.

    CAS  Article  Google Scholar 

  30. 30.

    Bengtsson M, Hammar O, Ohlsson B, Mandl T. Evaluation of gastrointestinal symptoms in different patient groups using the visual analogue scale for irritable bowel syndrome (VAS-IBS). BMC Gastroenterol. 2011;11.

  31. 31.

    Rahnavard Z, Eybpoosh S, Rezaei Homami M, Aghaei Meybodi HR, Azemati B, Heshmat R, et al. Vitamin D deficiency in healthy male population: results of the Iranian multi-center osteoporosis study. Iran J Public Health. 2010;39:45–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Kazemi A, Sharifi F, Jafari N, Mousavinasab N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. J Women'S Health. 2009;18:835–9.

    Article  Google Scholar 

  33. 33.

    Ahmad S, Mohammad Hassan L, Zahra N, Sedighe Akhavan K, Malihe G, Mehrdad S. Study to evaluate two dosage regimens of vitamin D through an academic year in middle school girls: a randomized trial. Acta Med Iran. 2011;49:780–3.

    Google Scholar 

  34. 34.

    Meybodi H, Bagheri A, Soltani A, Tehrani MM, Khashayar P, Heshmat R, et al. Effect of high dose versus conventional vitamin D supplement on serum 25(OH)D levels in women with low bone mass. Osteoporos Int. 2010;21:S744.

    Google Scholar 

Download references

Author contributions

C.E.W. undertook the searches, collated literature and wrote the first draft. E.A.W. co-conceived the study, reviewed and edited all drafts. B.M.C. co-conceived the study, undertook the searches, collated the literature and edited all drafts. All authors agreed the final version of the manuscript.

Funding

This work was jointly supported by BetterYou Ltd and The University of Sheffield.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Bernard M. Corfe.

Ethics declarations

Conflict of interest

The authors authored two of the systematically reviewed papers. BetterYou markets vitamin D supplements.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Williams, C.E., Williams, E.A. & Corfe, B.M. Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know?. Eur J Clin Nutr 72, 1358–1363 (2018). https://doi.org/10.1038/s41430-017-0064-z

Download citation

Further reading

Search

Quick links