Should we monitor vitamin B 12 levels in patients who have had end-ileostomy for inflammatory bowel disease?

Jayaprakash, A.; Creed, Tom; Stewart, Laura K.; Colton, Bradley; Mountford, R. A.; Standen, Graham R.; Probert, Chris

doi:10.1007/s00384-003-0556-2

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…While several studies have reported low average vitamin B 12 levels in CD patients, others have found contradicting results. 3 5 10 11 12 13 14 15 In our study, the patients with CD had significantly lower levels of serum vitamin B 12 than the UC patients and controls, while the prevalence of vitamin B 12 deficiency was similar in the UC patients and controls. These results echoed those of previously reported studies about the prevalence of vitamin B 12 deficiency in patients with UC.…”

Section: Discussionsupporting

confidence: 47%

“…While a number of previous studies indicated that CD patients tended to present vitamin B 12 deficiencies, others did not support this finding. 10 11 12 The reported prevalence of vitamin B 12 deficiency in patients with CD ranged from 5.6% to 38%. 13 Vitamin B 12 deficiency in IBD patients has multiple potential mechanisms, including inflammation of the distal ileum, the development of fistulas, small intestinal bacterial overgrowth, and resection of the distal ileum.…”

Section: Discussionmentioning

confidence: 99%

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Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China

Huang

Zhu

et al. 2017

Intest Res

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Background/AimsInflammatory bowel disease (IBD) primarily involves the intestinal tract and can affect vitamin absorption. This study was designed to assess the prevalence of vitamin B12 and folate deficiencies in patients with IBD, and to identify the risk factors associated with abnormal serum vitamin B12 and folate levels.MethodsWe evaluated the medical records of 195 patients with Crohn's disease (CD) and 62 patients with ulcerative colitis (UC), and selected 118 healthy subjects for the control group.ResultsThere were more CD patients with vitamin B12 deficiency than UC patients (14.9% vs. 3.2%, P=0.014) and controls (14.9% vs. 4.2%, P=0.003). The prevalence of folate deficiency was higher in CD patients than in controls (13.3% vs. 3.4%, P=0.004). There were no significant differences in the serum vitamin B12 and folate statuses of the UC and control groups. Patients with prior ileal or ileocolic resection showed a higher prevalence of abnormal vitamin B12 levels than those without prior resection (n=6/16, n=23/179; P=0.018). A disease duration within 5 years was a risk factor of abnormal folate levels in CD patients.ConclusionsThis study showed that vitamin B12 and folate deficiencies were more common in patients with CD than in UC patients and controls. Prior ileal or ileocolonic resection was a risk factor of serum vitamin B12 abnormalities, and a disease duration within 5 years was a risk factor of low serum folate levels in CD patients.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China

Huang

Zhu

et al. 2017

Intest Res

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“…We excluded this study based on our inclusion criteria (3). Jayaprakash et al reported their data without a healthy control group, and some of the patients they included had been receiving vitamin B12 supplementation [39]. We excluded this study based on our inclusion criteria (2) and (4).…”

Section: Discussionmentioning

confidence: 99%

Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis

et al. 2017

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Background: Inflammatory bowel disease (IBD) patients may be at risk of vitamin B12 and folate insufficiencies, as these micronutrients are absorbed in the small intestine, which is affected by IBD. However, a consensus has not been reached on the association between IBD and serum folate and vitamin B12 concentrations. Methods: In this study, a comprehensive search of multiple databases was performed to identify studies focused on the association between IBD and serum folate and vitamin B12 concentrations. Studies that compared serum folate and vitamin B12 concentrations between IBD and control patients were selected for inclusion in the meta-analysis. Results: The main outcome was the mean difference in serum folate and vitamin B12 concentrations between IBD and control patients. Our findings indicated that the average serum folate concentration in IBD patients was significantly lower than that in control patients, whereas the mean serum vitamin B12 concentration did not differ between IBD patients and controls. In addition, the average serum folate concentration in patients with ulcerative colitis (UC) but not Crohn’s disease (CD) was significantly lower than that in controls. This meta-analysis identified a significant relationship between low serum folate concentration and IBD. Conclusions: Our findings suggest IBD may be linked with folate deficiency, although the results do not indicate causation. Thus, providing supplements of folate and vitamin B12 to IBD patients may improve their nutritional status and prevent other diseases.

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“…Since ileostomies with resection of a large part of the terminal ileum were most frequent in the present series, the loss of vitamin B 12 (cobalamin) should also be considered [26] . Vitamin B 12 defi ciency is known to cause impaired myelinization and / or demyelization of neuronal cells [22] .…”

Section: Possible Causes For Diff Erences In Outcomesmentioning

confidence: 99%

Long-term Neurodevelopmental Impairment in Neonates Surgically Treated for Necrotizing Enterocolitis: Enterostomy Associated with a Worse Outcome

Roze²,

Braeckel³

et al. 2010

Eur J Pediatr Surg

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The results suggest that an enterostomy in SNEC patients could be associated with worse neurodevelopmental outcomes by the age of 6-13 years compared to a primary anastomosis, although the severity of illness was comparable between both groups. Further studies are needed to prevent selection bias and to elucidate the impact of abdominal surgical factors on neurodevelopmental outcome and the underlying pathophysiology.

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Should we monitor vitamin B 12 levels in patients who have had end-ileostomy for inflammatory bowel disease?

Abstract: We do not recommend routine screening for vitamin B12 deficiency in this group of patients unless they have undergone additional small bowel resection or have ongoing small bowel inflammation.

Cited by 11 publications

References 5 publications

Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China

Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China

Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis

Long-term Neurodevelopmental Impairment in Neonates Surgically Treated for Necrotizing Enterocolitis: Enterostomy Associated with a Worse Outcome

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Should we monitor vitamin B 12 levels in patients who have had end-ileostomy for inflammatory bowel disease?

Abstract: We do not recommend routine screening for vitamin B12 deficiency in this group of patients unless they have undergone additional small bowel resection or have ongoing small bowel inflammation.

Cited by 11 publications

References 5 publications

Status of serum vitamin B12and folate in patients with inflammatory bowel disease in China

Status of serum vitamin B12and folate in patients with inflammatory bowel disease in China

Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis

Long-term Neurodevelopmental Impairment in Neonates Surgically Treated for Necrotizing Enterocolitis: Enterostomy Associated with a Worse Outcome

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Product

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Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China

Status of serum vitamin B₁₂and folate in patients with inflammatory bowel disease in China