Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn's disease and intestinal resection.
We compared the intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with Crohn's disease and resections of the small bowel. Patients were subgrouped into those with small (less than 100 cm), intermediate (100-300 cm), and large (greater than 300 cm) resections. [3H]cholecalciferol or [3H]25-hydroxycholecalciferol were given orally and serial blood samples were taken for measurement of plasma radiolabeled vitamin. Absorption of both forms of the vitamin decreased with extent of resection but 25-hydroxycholecalciferol absorption was always greater than that of cholecalciferol. When compared with normal control subjects, 25-hydroxycholecalciferol absorption in these patients was better maintained than that of cholecalciferol. These data indicate that vitamin D malabsorption reflects the extent of distal small-bowel resection in Crohn's disease. Treatment with oral cholecalciferol is sufficient in those with small or moderate resections but oral 25-hydroxycholecalciferol supplementation may be preferred in those with a severe short-bowel syndrome.
Leichtmann
G A
GA
Department of Medicine, University of Chicago, IL.
Bengoa
J M
JM
Bolt
M J
MJ
Sitrin
M D
MD
D000042:Absorption; D001647:Bile Acids and Salts / Q000378:metabolism; D002112:Calcifediol / Q000493:pharmacokinetics*; D002762:Cholecalciferol / Q000493:pharmacokinetics*; D003424:Crohn Disease / Q000378:metabolism / Q000601:surgery*; D004386:Duodenum / Q000378:metabolism; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000601:surgery*; D009994:Osmolar Concentration; D011184:Postoperative Period
D001647:Bile Acids and Salts; D002762:Cholecalciferol; D002112:Calcifediol