1. Chronic functional constipation is strongly linked to vitamin D deficiency
- Author
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Massimo De Carne, Carla Maria Leone, Piero Porcelli, Alba Panarese, Giuseppe Riezzo, Francesco Pesce, Endrit Shahini, Palma Aurelia Iacovazzi, and Caterina Mammone Rinaldi
- Subjects
Quality of life ,Adult ,Male ,medicine.medical_specialty ,Constipation ,Gastrointestinal Diseases ,Anxiety ,Gastroenterology ,vitamin D deficiency ,03 medical and health sciences ,chemistry.chemical_compound ,Lactulose ,0302 clinical medicine ,Internal medicine ,Vitamin D and neurology ,Intestinal motility ,Prevalence ,Medicine ,Humans ,Prospective Studies ,Vitamin D ,Gastrointestinal Transit ,Irritable bowel syndrome ,Aged ,Chronic constipation ,business.industry ,Depression ,General Medicine ,Case Control Study ,Middle Aged ,medicine.disease ,Vitamin D Deficiency ,Healthy Volunteers ,chemistry ,030220 oncology & carcinogenesis ,Case-Control Studies ,Chronic Disease ,Functional constipation ,030211 gastroenterology & hepatology ,Calcifediol ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
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.
- Published
- 2019