Irritable bowel syndrome: a review of the general aspects and the potential role of vitamin D

ABSTRACT

Introduction: Irritable Bowel Syndrome (IBS) is a bowel disorder leading to symptoms such as abdominal pain, modifications in the motility and bowel habits, distention, bloating, and gas. Vitamin D (VD) may interfere in a plethora of cellular mechanisms, and act directly or indirectly in the regulation of the microbiome, the release of anti-microbial peptides, modulation of the immune system and inflammation processes; which in turn, may positively interfere with the altered gut function. The main purpose of this review was to survey studies involving the impacts of VD on IBS.

Area covered: Eligible studies including the term VD and IBS were searched in the MEDLINE–PubMed and EMBASE (2009–2018). VD may act direct or indirectly in the regulation of the gut microbiome, immune response, and psychosocial factors that may be included in the list of IBS triggering factors.

Expert opinion: Once VD plays an essential role in many processes associated with IBS, its deficiency may be associated with IBS, and the supplementation could help in the therapeutic approach for this condition. For these reasons, the understanding of the association of VD in IBS is indispensable for the development of new strategies that could improve the quality of life of the patient.

KEYWORDS:

• Irritable bowel syndrome
• vitamin D
• low-grade inflammation
• anxiety
• depression

Article highlights

• Irritable bowel syndrome (IBS) is a chronic and prevalent condition that leads to a reduction of quality of life of the patient and is associated with important burden to the healthcare systems.

• Few drugs are available for the treatment of IBS, but in many cases, they are not efficient to reduce symptoms.

• VD is a fat-soluble steroid hormone that may interfere with a plethora of cellular mechanisms, and its deficiency is linked to many pathologies such as inflammatory bowel disorders, colorectal cancer, depression, sclerosis, and several other pathologies.

• Due to the role of VD in many of these processes associated with IBS, we suggest that its deficiency may be related to this condition and supplementation may aid in the control and maintenance of remission.

• New studies should be performed to investigate the doses that would be necessary for different age range, ethnicities, and season. With these data, an optimal protocol of supplementation could be constructed.

Acknowledgments

We acknowledge Renato Vono Fernandes for helping us with the confection of the figures (http://vono.art.br).

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

The contribution of the authors

S M Barbalho, R A Goulart, A C Araújo, and E L Guiguer designed the manuscript and wrote the final version. M D Bechara contributed to the revision of the literature and reviewed the final version of the paper. We accept equal responsibility for the accuracy of the contents of this paper, and we do not have financial interest linked to this work.

Additional information

Funding

This paper was not funded.