title: Micronutrient deficiencies in inflammatory bowel disease.
abstract: OBJECTIVE
  Malnutrition, protein-energy, and micronutrient deficiencies are common among patients with inflammatory bowel disease (IBD). The deficiencies are a manifestation of the complicated disease and a cause of morbidity. The present review summarizes recent advances and evidence-based knowledge regarding micronutrients in relation to patients with IBD.
  
  
  RESULTS
  Micronutrient deficiencies occur in more than half of patients with IBD. Most common are deficiencies of iron, B12, vitamin D, vitamin K, folic acid, selenium, zinc, vitamin B6, and vitamin B1. Deficiencies are more common in Crohn's disease than in ulcerative colitis, and more in active disease than at times of remission. Micronutrient deficiency is associated with prolonged and complicated course of disease. Iron deficiency is the most common cause for anemia. Definite diagnosis of B12 deficiency cannot be established by serum levels alone. Vitamin D and vitamin K deficiencies are thought to be associated with heightened inflammatory state. The relationship of these deficiencies with bone disease is controversial. The present review focuses on the significance, epidemiology, treatment options, and recommendations regarding micronutrient deficiencies in IBD.
  
  
  CONCLUSIONS
  Micronutrient deficiencies are common and have clinical significance. High suspicion for micronutrient deficiencies is advocated so that treatable causes of morbidity are treated appropriately and late and irreversible sequlae are prevented.
authors.affiliation: Department of Gastroenterology, Rambam Health Care Campus and Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Weisshof
authors.forename: Irit
authors.initials: I
authors.lastname: Chermesh
mesh_terms: D001361:Avitaminosis / Q000097:blood / Q000209:etiology; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications*; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D003677:Deficiency Diseases / Q000097:blood / Q000209:etiology*; D006801:Humans; D018977:Micronutrients / Q000097:blood / Q000172:deficiency; D009752:Nutritional Status; D014131:Trace Elements / Q000097:blood / Q000172:deficiency*; D014815:Vitamins / Q000097:blood
chemical_list: D018977:Micronutrients; D014131:Trace Elements; D014815:Vitamins