Chronic functional constipation is associated with low vitamin D - several studies

Prevelance of Chronic Constipation

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Chronic functional constipation is strongly linked to vitamin D deficiency - April 2019

World J Gastroenterol. 2019 Apr 14;25(14):1729–1740. doi: 10.3748/wjg.v25.i14.1729
Alba Panarese 1, Francesco Pesce 2, Piero Porcelli 3, Giuseppe Riezzo 4, Palma Aurelia Iacovazzi 5, Carla Maria Leone 6, Massimo De Carne 7, Caterina Mammone Rinaldi 8, Endrit Shahini 9,10

BACKGROUND
Few studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not well-defined.

AIM
To investigate the relationship between serum 25-hydroxyvitamin D levels and functional chronic constipation associated to intestinal motility disorders.

METHODS
We performed a prospective case-control study, from May-June to November 2017. Glucose/lactulose breath tests, radiopaque markers (multiple capsule techniques) and wireless motility capsule analysis were used to assess colonic and oro-cecal transit time, after excluding small-intestinal bacterial overgrowth condition. Then, we measured 25-hydroxyvitamin D levels in patients with intestinal motility disorders and we further evaluated the influence of intestinal motility disorders on psychological symptoms/quality of life using validated questionnaires, the Irritable Bowel Syndrome Quality of life (IBS-QOL), the Short Form Health Survey 12, and the Hospital Anxiety and Depression Scale 14 (HADS-14 A and HADS-14 D).

RESULTS
We enrolled 86 patients with chronic functional constipation associated to intestinal motility disorders and 86 matched healthy subjects. Patients with intestinal motility disorders had lower 25-hydroxyvitamin D levels (P < 0.001), and they showed a significant impairment of all health-related quality of life and psychological tests (IBS-QOL, Short Form Health Survey 12-Physical Component Summary, Short Form Health Survey 12-Mental Component Summary, HADS-14 A and HADS-14 D), as compared to the control group (P < 0.001), which significantly correlated with low vitamin D levels (r = - 0.57, P < 0.001; r = 0.21, P = 0.01; r = - 0.48, P < 0.001; r = - 0.57, P < 0.001; r = - 0.29, P < 0.001, respectively). At multivariate analysis vitamin D low levels remained a significant independent risk factor for the occurrence of intestinal motility disorder (odds ratio = 1.19; 95% confidence interval: 1.14-1.26, P < 0.001).

CONCLUSION
Vitamin D deficiency, anxiety and depression symptoms are commonly associated with chronic functional constipation induced by intestinal motility disorders. Vitamin D serum levels should be routinely measured in these patients.

Core tip: Intestinal motility disorders, which are disabling conditions associated with chronic constipation, have been examined in only A few studies. Patients with intestinal motility disorders are frequently affected by vitamin D deficiency, which is strongly associated to anxiety, depression symptoms and to severe impairment of quality of life. These data suggest that vitamin D serum levels should be routinely measured, and its supplementation should be evaluated in patients with intestinal motility disorders.
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VitaminDWiki - Constipation - Magnesium, Calcium and cofactors

The worse constipation of my life resulted from high-dose vitamin D which resulted in low Magnesium, which caused my constipation. (I had > 100 ng/mL while taking no Magnesium)

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Screening of vitamin D deficiency in children with chronic functional constipation - Nov 2024

Gastroenterology Rev DOI: https://doi.org/10.5114/pg.2024.144833
Rasha H. Metwally Department of Pediatrics, Alexandria University, Alexandria, Egypt

Introduction: Vitamin D deficiency is one of the most common nutritional deficiencies worldwide. Chronic functional consti­pation is one of the most common gastrointestinal disorders in childhood in developing and developed countries. Vitamin D has been linked to different systemic diseases. The medical domain has recently been interested in the role of vitamin D.

Aim: To screen for vitamin D deficiency and insufficiency among children with chronic functional constipation.

Material and methods: It was a cross-sectional study. Two groups of children were collected at the outpatient clinic at Al­exandria University. Children who fulfilled Rome IV criteria of chronic functional constipation were assigned to the first group (Constipation group). Children who did not have chronic functional constipation were considered as the second group (Healthy control group). Vitamin D level was measured in both groups. Statistical analysis used: Data were fed to the computer and ana­lysed using IBM SPSS software package version 20.0. Quantitative data were described using range (minimum and maximum), mean, standard deviation, and median.

Results: Vitamin D levels were significantly deficient or at least insufficient in the group of children with chronic functional constipation.

Conclusions: Chronic functional constipation is associated with vitamin D deficiency and insufficiency in children.
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VitaminDWiki – Overview Gut and vitamin D contains

• Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
• Celiac disease has a strong genetic component.
  • Most, but not all, people with celiac disease have a gene variant.
  • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
  • Celiac disease causes poor absorption of nutrients such as vitamin D.
  • Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
  • The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
• Review in Nov 2013 found that Vitamin D helped
  Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
• All items in category gut and vitamin D 207 items

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VitaminDWiki – Overview Gut and vitamin D contains gut-friendly information

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VitaminDWiki – Irritable Bowel Syndrome and Vitamin D - many studies

Note: IBS-C focuses on Constipation

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What is the difference between chronic functional constipation and chronic constipation (Preplexity AI Nov 2024)

The key distinction between chronic functional constipation and chronic constipation lies in their underlying causes and diagnostic criteria:
Chronic Constipation
Chronic constipation is a broader term that encompasses all forms of long-term constipation, including both:Primary (Functional) Cases:

• No identifiable underlying medical cause   1   2
• Diagnosed using Rome III criteria
• Symptoms present for at least 3 months   2

Secondary Cases:

• Caused by specific medical conditions
• Results from medications
• Linked to anatomical problems   2

Chronic Functional Constipation
This is a specific subset of chronic constipation characterized by:Key Features:

• No identifiable organic cause or underlying medical condition   4
• Must meet specific diagnostic criteria
• Symptoms persist for at least 3 months with onset 6 months prior   4

Types of Functional Constipation:

• Normal transit constipation (most common)
• Slow transit constipation
• Outlet constipation (pelvic floor dysfunction)   3

Diagnostic Criteria
For chronic functional constipation, patients must experience at least two of the following:

• Straining during >25% of defecations
• Lumpy/hard stools in >25% of defecations
• Incomplete evacuation sensation in >25% of defecations
• Anorectal blockage in >25% of defecations
• Manual maneuvers needed in >25% of defecations
• Fewer than three bowel movements per week   4

The main distinction is that chronic constipation includes all cases of persistent constipation, while chronic functional constipation specifically refers to cases where there is no identifiable underlying medical cause   1   2

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Management of functional constipation in children and adults - Jan 2020

Vitamin D not mentioned in the abstract

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Clinical Manifestations among Children with Chronic Functional Constipation - Jan 2015

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