Chronic functional constipation is strongly linked to vitamin D deficiency

Alba Panarese, Francesco Pesce, Piero Porcelli, Giuseppe Riezzo, Palma Aurelia Iacovazzi, Carla Maria Leone, Massimo De Carne, Caterina Mammone Rinaldi, Endrit Shahini

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1729-1740
Number of pages12
JournalWorld Journal of Gastroenterology
Volume25
Issue number14
DOIs
Publication statusPublished - Apr 14 2019

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Panarese, A., Pesce, F., Porcelli, P., Riezzo, G., Iacovazzi, P. A., Leone, C. M., De Carne, M., Rinaldi, C. M., & Shahini, E. (2019). Chronic functional constipation is strongly linked to vitamin D deficiency. World Journal of Gastroenterology, 25(14), 1729-1740. https://doi.org/10.3748/wjg.v25.i14.1729