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.
aDivision of Pediatric Gastroenterology, Marshfield Clinic, Marshfield, Wisconsin
bDivision of Pediatric Gastroenterology, Steven and Alexandra Cohen Children's Medical Center of NY, Northwell Health, Lake Success
cHofstra Northwell School of Medicine, Hempstead, New York, USA
Correspondence to Toba Weinstein, MD, Division of Pediatric Gastroenterology, Associate Professor of Pediatrics, Hofstra Northwell School of Medicine, Steven and Alexandra Cohen Children's Medical Center of NY, Northwell Health, 1991 Marcus Avenue, Suite M100, Lake Success, New York, NY 11042, USA. Tel: +1 516 472 3650; e-mail: firstname.lastname@example.org