Abstract
A wide range of nutritional disturbances may be found in patients with Crohn's disease. As more sophisticated tests become available to measure vitamin and trace element deficiencies, so these are being recognized as complications of Crohn's disease. It is important to recognize nutritional deficiencies at an early stage and initiate appropriate treatment. Otherwise many patients, experiencing what can be a chronic and debilitating illness, may suffer unnecessarily from the consequences of deprivation of vital nutrients.
Full text
PDF







Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- ATWELL J. D., DUTHIE H. L. THE ABSORPTION OF WATER, SODIUM, AND POTASSIUM FROM THE ILEUM OF HUMANS SHOWING THE EFFECTS OF REGIONAL ENTERITIS. Gastroenterology. 1964 Jan;46:16–22. [PubMed] [Google Scholar]
- Aggett P. J., Harries J. T. Current status of zinc in health and disease states. Arch Dis Child. 1979 Dec;54(12):909–917. doi: 10.1136/adc.54.12.909. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BEST C. N. Subacute combined degeneration of spinal cord after extensive resection of ileum in Crohn's disease: report of a case. Br Med J. 1959 Oct 31;2(5156):862–864. doi: 10.1136/bmj.2.5156.862. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BURKE J. The treatment of steatorrhoea in Crohn's disease. Br Med J. 1953 Jan 31;1(4804):239–242. doi: 10.1136/bmj.1.4804.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Batchelor A. J., Watson G., Compston J. E. Changes in plasma half-life and clearance of 3H-25-hydroxyvitamin D3 in patients with intestinal malabsorption. Gut. 1982 Dec;23(12):1068–1071. doi: 10.1136/gut.23.12.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beeken W. L., Busch H. J., Sylwester D. L. Intestinal protein loss in Crohn's disease. Gastroenterology. 1972 Feb;62(2):207–215. [PubMed] [Google Scholar]
- Beeken W. L., Kanich R. E. Microbial flora of the upper small bowel in Crohn's disease. Gastroenterology. 1973 Sep;65(3):390–397. [PubMed] [Google Scholar]
- Beeken W. L. Remediable defects in Crohn disease: a prospective study of 63 patients. Arch Intern Med. 1975 May;135(5):686–690. [PubMed] [Google Scholar]
- Beisel W. R. Single nutrients and immunity. Am J Clin Nutr. 1982 Feb;35(2 Suppl):417–468. doi: 10.1093/ajcn/35.2.417. [DOI] [PubMed] [Google Scholar]
- Block G. E., Moossa A. R., Simonowitz D. The operative treatment of Crohn's disease in childhood. Surg Gynecol Obstet. 1977 May;144(5):713–717. [PubMed] [Google Scholar]
- Burbige E. J., Huang S. H., Bayless T. M. Clinical manifestations of Crohn's disease in children and adolescents. Pediatrics. 1975 Jun;55(6):866–871. [PubMed] [Google Scholar]
- COOKE W. T. Nutritional and metabolic factors in the aetiology and treatment of regional ileitis; Hunterian lecture delivered at the Royal College of Surgeons of England on 28th April 1955. Ann R Coll Surg Engl. 1955 Sep;17(3):137–158. [PMC free article] [PubMed] [Google Scholar]
- Chen L. C., Chowdhury A., Huffman S. L. Anthropometric assessment of energy-protein malnutrition and subsequent risk of mortality among preschool aged children. Am J Clin Nutr. 1980 Aug;33(8):1836–1845. doi: 10.1093/ajcn/33.8.1836. [DOI] [PubMed] [Google Scholar]
- Cobb T. C., Robson M. C. Regional enteritis presenting as hypoproteinemia without intestinal symptoms. JAMA. 1969 Feb 17;207(7):1351–1352. [PubMed] [Google Scholar]
- Compston J. E., Ayers A. B., Horton L. W., Tighe J. R., Creamer B. Osteomalacia after small-intestinal resection. Lancet. 1978 Jan 7;1(8054):9–12. doi: 10.1016/s0140-6736(78)90358-6. [DOI] [PubMed] [Google Scholar]
- Compston J. E., Creamer B. Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection. Gut. 1977 Mar;18(3):171–175. doi: 10.1136/gut.18.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dawson A. M. Nutritional disturbances in Crohn's disease. Br J Surg. 1972 Oct;59(10):817–819. doi: 10.1002/bjs.1800591018. [DOI] [PubMed] [Google Scholar]
- Declercq S. S., Meredith P. C., Rosenthal A. R. Experimental siderosis in the rabbit: correlation between electroretinography and histopathology. Arch Ophthalmol. 1977 Jun;95(6):1051–1058. doi: 10.1001/archopht.1977.04450060138014. [DOI] [PubMed] [Google Scholar]
- Dotevall G., Kock N. G. Absorption studies in regional enterocolitis (Mb. Crohn). Scand J Gastroenterol. 1968;3(3):293–298. doi: 10.3109/00365526809180603. [DOI] [PubMed] [Google Scholar]
- Driscoll R. H., Jr, Meredith S. C., Sitrin M., Rosenberg I. H. Vitamin D deficiency and bone disease in patients with Crohn's disease. Gastroenterology. 1982 Dec;83(6):1252–1258. [PubMed] [Google Scholar]
- Dyer N. H., Child J. A., Mollin D. L., Dawson A. M. Anaemia in Crohn's disease. Q J Med. 1972 Oct;41(164):419–436. [PubMed] [Google Scholar]
- Dyer N. H., Dawson A. M. The incidence and significance of liver dysfuntion in Crohn's disease. Digestion. 1972;5(6):317–325. doi: 10.1159/000197205. [DOI] [PubMed] [Google Scholar]
- Dyer N. H., Dawson A. M. The significance of serum cholesterol measurements in Crohn's disease. Scand J Gastroenterol. 1971;6(3):253–256. doi: 10.3109/00365527109180703. [DOI] [PubMed] [Google Scholar]
- Eade M. N., Cooke W. T., Williams J. A. Clinical and hematologic features of Crohn's disease. Surg Gynecol Obstet. 1972 Apr;134(4):643–646. [PubMed] [Google Scholar]
- Elsborg L., Larsen L. Folate deficiency in chronic inflammatory bowel diseases. Scand J Gastroenterol. 1979;14(8):1019–1024. [PubMed] [Google Scholar]
- Fleming C. R., Huizenga K. A., McCall J. T., Gildea J., Dennis R. Zinc nutrition in Crohn's disease. Dig Dis Sci. 1981 Oct;26(10):865–870. doi: 10.1007/BF01309488. [DOI] [PubMed] [Google Scholar]
- Gerlach K., Morowitz D. A., Kirsner J. B. Symptomatic hypomagnesemia complicating regional enteritis. Gastroenterology. 1970 Oct;59(4):567–574. [PubMed] [Google Scholar]
- Gerson C. D., Cohen N., Janowitz H. D. Small intestinal absorptive function in regional enteritis. Gastroenterology. 1973 May;64(5):907–912. [PubMed] [Google Scholar]
- Gerson C. D., Fabry E. M. Ascorbic acid deficiency and fistula formation in regional enteritis. Gastroenterology. 1974 Sep;67(3):428–433. [PubMed] [Google Scholar]
- Gotlin R. W., Dubois R. S. Nyctohemeral growth hormone levels in children with growth retardation and inflammatory bowel disease. Gut. 1973 Mar;14(3):191–195. doi: 10.1136/gut.14.3.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gudmand-Hoyer E., Jarnum S. Incidence and clinical significance of lactose malabsorption in ulcerative colitis and Crohn's disease. Gut. 1970 Apr;11(4):338–343. doi: 10.1136/gut.11.4.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harries A. D., Jones L., Heatley R. V., Rhodes J., Fitzsimons E. Mid-arm circumference as simple means of identifying malnutrition in Crohn's disease. Br Med J (Clin Res Ed) 1982 Nov 6;285(6351):1317–1318. doi: 10.1136/bmj.285.6351.1317. [DOI] [PubMed] [Google Scholar]
- Hertzberg J. N., Myren J., Semb L. S. Regional enterocolitis (Crohn's disease). Absorption studies after surgical treatment. Scand J Gastroenterol. 1969;4(7):569–573. [PubMed] [Google Scholar]
- Hill G. L., Blackett R. L., Pickford I. R., Bradley J. A. A survey of protein nutrition in patients with inflammatory bowel disease--a rational basis for nutritional therapy. Br J Surg. 1977 Dec;64(12):894–896. doi: 10.1002/bjs.1800641216. [DOI] [PubMed] [Google Scholar]
- Hoffbrand A. V., Stewart J. S., Booth C. C., Mollin D. L. Folate deficiency in Crohn's disease: incidence, pathogenesis, and treatment. Br Med J. 1968 Apr 13;2(5597):71–75. doi: 10.1136/bmj.2.5597.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Homer D. R., Grand R. J., Colodny A. H. Growth, course, and prognosis after surgery for Crohn's disease in children and adolescents. Pediatrics. 1977 May;59(5):717–725. [PubMed] [Google Scholar]
- Hughes R. G., Williams N. Leucocyte ascorbic acid in Crohn's disease. Digestion. 1978;17(3):272–274. doi: 10.1159/000198118. [DOI] [PubMed] [Google Scholar]
- Jacobs A., Worwood M. Ferritin in serum. Clinical and biochemical implications. N Engl J Med. 1975 May 1;292(18):951–956. doi: 10.1056/NEJM197505012921805. [DOI] [PubMed] [Google Scholar]
- Johansson C., Allgén L. G., Hellström L. Tryptophan concentration in serum of patients with regional enteritis. Its possible relation to depression. Acta Med Scand. 1973 Dec;194(6):551–552. [PubMed] [Google Scholar]
- KALSER M. H., ROTH J. L., TUMEN H., JOHNSON T. A. Relation of small bowel resection to nutrition in man. Gastroenterology. 1960 Apr;38:605–615. [PubMed] [Google Scholar]
- KIEFER E. D., ARNOLD W. T. Nutritional problems following resection of the small intestine for regional ileitis. J Am Med Assoc. 1950 Nov 11;144(11):903–909. doi: 10.1001/jama.1950.02920110015005. [DOI] [PubMed] [Google Scholar]
- KIEFER E. D. Recurrent regional ileitis. Surg Clin North Am. 1955 Jun;LAHEY:801–807. doi: 10.1016/s0039-6109(16)34597-2. [DOI] [PubMed] [Google Scholar]
- Kelsay J., Baysal A., Linkswiler H. Effect of vitamin B6 depletion on the pyridoxal, pyridoxamine and pyridoxine content of the blood and urine of men. J Nutr. 1968 Apr;94(4):490–494. doi: 10.1093/jn/94.4.490. [DOI] [PubMed] [Google Scholar]
- Kelts D. G., Grand R. J., Shen G., Watkins J. B., Werlin S. L., Boehme C. Nutritional basis of growth failure in children and adolescents with Crohn's disease. Gastroenterology. 1979 Apr;76(4):720–727. [PubMed] [Google Scholar]
- Kirschner B. S., Voinchet O., Rosenberg I. H. Growth retardation in inflammatory bowel disease. Gastroenterology. 1978 Sep;75(3):504–511. [PubMed] [Google Scholar]
- Kraus J., Schneider R. Pernicious anemia caused by Crohn's disease of the stomach. Am J Gastroenterol. 1979 Feb;71(2):202–205. [PubMed] [Google Scholar]
- Krause U., Bergman L., Norlén B. J. Crohn's disease. A clinical study based on 186 patients. Scand J Gastroenterol. 1971;6(1):97–108. doi: 10.3109/00365527109180677. [DOI] [PubMed] [Google Scholar]
- Krawitt E. L., Beeken W. L., Janney C. D. Calcium absorption in Crohn's disease. Gastroenterology. 1976 Aug;71(2):251–254. [PubMed] [Google Scholar]
- Linaker B. D. Scurvy and vitamin C deficiency in Crohn's disease. Postgrad Med J. 1979 Jan;55(639):26–29. doi: 10.1136/pgmj.55.639.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MEYNELL M. J., COOKE W. T., COX E. V., GADDIE R. Serum-cyanocobalamin level in chronic intestinal disorders. Lancet. 1957 May 4;272(6975):901–904. doi: 10.1016/s0140-6736(57)91223-0. [DOI] [PubMed] [Google Scholar]
- Main A. N., Morgan R. J., Russell R. I., Hall M. J., MacKenzie J. F., Shenkin A., Fell G. S. Mg deficiency in chronic inflammatory bowel disease and requirements during intravenous nutrition. JPEN J Parenter Enteral Nutr. 1981 Jan-Feb;5(1):15–19. doi: 10.1177/014860718100500115. [DOI] [PubMed] [Google Scholar]
- McCaffery T. D., Nasr K., Lawrence A. M., Kirsner J. B. Severe growth retardation in children with inflammatory bowel disease. Pediatrics. 1970 Mar;45(3):386–393. [PubMed] [Google Scholar]
- McClain C., Soutor C., Zieve L. Zinc deficiency: a complication of Crohn's disease. Gastroenterology. 1980 Feb;78(2):272–279. [PubMed] [Google Scholar]
- Mekhjian H. S., Switz D. M., Melnyk C. S., Rankin G. B., Brooks R. K. Clinical features and natural history of Crohn's disease. Gastroenterology. 1979 Oct;77(4 Pt 2):898–906. [PubMed] [Google Scholar]
- Mills P. R., Fell G. S. Zinc and inflammatory bowel disease. Am J Clin Nutr. 1979 Nov;32(11):2172–2173. doi: 10.1093/ajcn/32.11.2172. [DOI] [PubMed] [Google Scholar]
- Nishi Y., Lifshitz F., Bayne M. A., Daum F., Silverberg M., Aiges H. Zinc status and its relation to growth retardation in children with chronic inflammatory bowel disease. Am J Clin Nutr. 1980 Dec;33(12):2613–2621. doi: 10.1093/ajcn/33.12.2613. [DOI] [PubMed] [Google Scholar]
- O'Donoghue D. P., Dawson A. M. Crohn's disease in childhood. Arch Dis Child. 1977 Aug;52(8):627–632. doi: 10.1136/adc.52.8.627. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pemberton J. D., Brown P. W. REGIONAL ILEITIS. Ann Surg. 1937 May;105(5):855–870. doi: 10.1097/00000658-193705000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Penny W. J., Mayberry J. F., Aggett P. J., Gilbert J. O., Newcombe R. G., Rhodes J. Relationship between trace elements, sugar consumption, and taste in Crohn's disease. Gut. 1983 Apr;24(4):288–292. doi: 10.1136/gut.24.4.288. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pollack S., Enat R., Haim S., Zinder O., Barzilai D. Pellagra as the presenting manifestation of Crohn's disease. Gastroenterology. 1982 May;82(5 Pt 1):948–952. [PubMed] [Google Scholar]
- Rude R. K., Oldham S. B., Singer F. R. Functional hypoparathyroidism and parathyroid hormone end-organ resistance in human magnesium deficiency. Clin Endocrinol (Oxf) 1976 May;5(3):209–224. doi: 10.1111/j.1365-2265.1976.tb01947.x. [DOI] [PubMed] [Google Scholar]
- SCUDAMORE H. H. Observations on secondary malabsorption syndromes of intestinal origin. Regional enteritis, lymphoma, jejunal diverticulosis, gastrojejunocolic fistula. Ann Intern Med. 1961 Sep;55:433–447. doi: 10.7326/0003-4819-55-3-433. [DOI] [PubMed] [Google Scholar]
- Sandstead H. H. Zinc nutrition in the United States. Am J Clin Nutr. 1973 Nov;26(11):1251–1260. doi: 10.1093/ajcn/26.11.1251. [DOI] [PubMed] [Google Scholar]
- Solomons N. W., Rosenberg I. H., Sandstead H. H., Vo-Khactu K. P. Zinc deficiency in Crohn's disease. Digestion. 1977;16(1-2):87–95. doi: 10.1159/000198059. [DOI] [PubMed] [Google Scholar]
- Sonnenberg A., Ehms H., Sonnenberg G. E., Strohmeyer G. 25-hydroxycholecalciferol serum levels in patients with Crohn's disease. Acta Hepatogastroenterol (Stuttg) 1977 Aug;24(4):293–295. [PubMed] [Google Scholar]
- Sturniolo G. C., Molokhia M. M., Shields R., Turnberg L. A. Zinc absorption in Crohn's disease. Gut. 1980 May;21(5):387–391. doi: 10.1136/gut.21.5.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tenore A., Berman W. F., Parks J. S., Bongiovanni A. M. Basal and stimulated serum growth hormone concentrations in inflammatory bowel disease. J Clin Endocrinol Metab. 1977 Apr;44(4):622–628. doi: 10.1210/jcem-44-4-622. [DOI] [PubMed] [Google Scholar]
- Thomson A. B., Brust R., Ali M. A., Mant M. J., Valberg L. S. Iron deficiency in inflammatory bowel disease. Diagnostic efficacy of serum ferritin. Am J Dig Dis. 1978 Aug;23(8):705–709. doi: 10.1007/BF01072356. [DOI] [PubMed] [Google Scholar]
- VAN PATTER W. N., BARGEN J. A., DOCKERTY M. B., FELDMAN W. H., MAYO C. W., WAUGH J. M. Regional enteritis. Gastroenterology. 1954 Mar;26(3):347–450. [PubMed] [Google Scholar]
- Wolman S. L., Anderson G. H., Marliss E. B., Jeejeebhoy K. N. Zinc in total parenteral nutrition: requirements and metabolic effects. Gastroenterology. 1979 Mar;76(3):458–467. [PubMed] [Google Scholar]