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VERIFIED CONTENTAuthor: Dominika Wilk

Crohn's disease or ulcerative colitis are inflammatory bowel diseases that lead to a poorer absorption of nutrients, and thus a deficiency of many important vitamins and minerals. If the body is not put into remission in time and the intestinal microflora is not balanced, it will weaken the body and increase the risk of other diseases.

The most popular inflammatory bowel diseases are Crohn's disease and ulcerative colitis. Both of these diseases can destroy the intestines to such an extent that the absorption of nutrients is worse, and thus the body is malnourished and many deficiencies of vitamins and minerals arise. Malnutrition in the above-mentioned units may also result from an increased demand for certain ingredients in chronic diseases, insufficient dietary supply of appropriate nutrients, excessive loss of these ingredients with the stool, e.g. in chronic diarrhea.

Crohn's disease

Crohn's disease is inflammatory bowel disease that can affect any part of the digestive tract. So it can appear in the mouth, duodenum, or large intestine.

This disease differs from ulcerative colitis in that the infiltrates occur over the entire thickness of the intestine, and in UC, the infiltration is limited to the mucosa and submucosa of the large intestine.

The factors that cause this disease are not fully known. Genetic, immunological, environmental and microbiological factors are suspected here.

Symptoms characteristic of Crohn's disease in the presence of intestinal inflammation are:

  • diarrhea,
  • cramping stomach pains,
  • significant weight loss,
  • as well as anemia visible in the results of laboratory tests.

The physical examination also shows the presence of skin and perianal lesions, as well as inflammatory changes in the gastrointestinal tract - but they only affect a certain percentage of patients.

There are 4 types of the diseaseOf Leśniowski-Crohn's:

  • A type that only covers the small intestine, which includes both the duodenum, jejunum, and ileum.
  • A type involving only the inflammation of the colon.
  • Type for the terminal ileum.
  • Type refers to the ileo-colonic and entero-colonic areas.

Regardless of the subtype, Crohn's disease has both periods of remission, when the disease is inactive, and periods of exacerbation, when symptoms become severe due to inflammation.

Ulcerative colitis

Ulcerative colitis is an incurable inflammatory bowel disease that most often affects young people between the ages of 20 and 40. This disease affects the mucosa and submucosa of the large intestine, and initially affects the rectum, and then spreads to the colon and the entire colon.

The most characteristic symptoms of UC are diarrhea with an admixture of blood or mucus (however, when we only deal with rectal involvement, constipation may appear).

In addition, the patient usually experiences pain on the left side of the abdomen, which sometimes disappears after a bowel movement; feeling of constant pressure on your stools; loose stools that you pass very often. At the same time, the patient feels weak, sometimes has a fever, and a fistula may appear in his intestines.

There are three forms of UZJG:

  • inflammatory lesions covering the rectal area,
  • left-sided UC (the affected area is the area from the rectum to the splenic flexure of the colon),
  • entire colon is involved.

Iron deficiency in inflammatory bowel diseases

In inflammatory bowel diseases, especially in UC, iron deficiency is frequent. This is mainly due to the excessive loss of this element during diarrhea, bleeding or due to the removal of a fragment of the large intestine. Iron is an essential element for the production of blood. If there is not enough of it, erythropathy, the process of the formation of red blood cells in the bone marrow, is disturbed.

The blood cells that form then are small and have an insufficient amount of hemoglobin. Hemoglobin carries oxygen to all cells. When it is deficient, the organism becomes weaker and the person gets tired more. People who have UC, and at the same time too little iron, may therefore suffer from constant headaches, concentration disorders, excessive sleepiness, faster fatigue, apathy, eating disorders, an increased incidence of gingivitis and inflammation of the tongue.

To determine if there is a shortageiron, it is worth doing blood tests and examining first of all: iron level, ferritin level (iron storage), transferrin, TIBC, iron curve and a blood count.

If we find that we have a deficiency of iron, it is worth reaching for products rich in this element, namely: pork liver, turkey / rabbit liver, nuts, whole grains.

It should be remembered, however, that some food products may inhibit the absorption of iron - they are mainly hindered by oxalates contained in e.g. spinach, tannins present in black tea, calcium present in dairy products, phytates found in legumes, phosphates present in colorful drinks. In turn, the ingredient that supports the absorption of iron is vitamin C.

However, the most important aspect in improving iron absorption is bringing the body into remission and sealing the intestinal barrier. This will reduce the amount of iron lost with the stool and improve the absorption of nutrients by the intestinal villi.

Inflammatory bowel diseases and vitamin B12 deficiency

The receptors necessary for the absorption of the vitamin B12-IF complex (transport protein) are found only in the ileum. If this section of the intestine has a medical condition, then the absorption of this vitamin is difficult. Vitamin B12 is necessary for the breakdown of erythroblasts, which make up red blood cells.

Therefore, the produced red blood cells are not properly shaped, for example too large, and this leads to megaloblastic anemia. In addition to anemia, the consequence of vitamin B12 deficiency may be neurological diseases, polyneuritis.

The minor but no less bothersome ailments caused by the deficiency of this vitamin include:

  • loss of appetite,
  • loss of taste,
  • feeling disgusted at the thought of eating meat or fried foods,
  • ulcers appearing at the corners of the mouth,
  • diarrhea or constipation,
  • nausea,
  • memory impairment,
  • visual impairment.

In order to improve the absorption of vitamin B12, it is necessary to stabilize the state of the intestines, introduce the state of eubiosis. In addition, increasing the amount of food products rich in this vitamin, e.g. meat (if someone is not disgusted or not vegan), fish, egg yolks, milk. In many cases, it is also necessary to supplement this vitamin.

Inflammatory bowel diseases and vitamin A, D, E, K deficiency

Weakened intestinal barrier and leaky intestines in inflammatory bowel diseases lead to malabsorption of vitaminsfat-soluble, i.e. A, D, E, K. Vitamin A plays an important role in the synthesis of steroid hormones and is responsible for the proper functioning of the epithelium.

Its deficiency leads to: fertility disorders, visual impairment, as well as drying out of the conjunctiva and the cornea, as well as the softening and clouding of the latter.

Deficiency of this vitamin also promotes the formation of gallstones and the formation of stones in the urinary tract.

Vitamin D, on the other hand, is important for the immune system. With its deficiency, immunity decreases and it is easier to get infections or inflammations. Vitamin E is an irreplaceable antioxidant that can reduce inflammation because it reduces the amount of free radicals and protects proteins, lipids and DNA from oxidation.

In addition, it seals and strengthens cell membranes, has a protective effect on red blood cells and endothelium, which reduces the risk of cardiovascular diseases. Its deficiency, in turn, increases the likelihood of neurological diseases or fertility problems.

Inflammatory bowel diseases and magnesium deficiency

As a result of chronic diarrhea, chronic inflammation, fistulas, or the removal of a part of the jejunum or ileum, there is a significant magnesium deficiency. This has many unpleasant consequences, as magnesium is a cofactor of many important changes in the body and its deficiency disrupts the functioning of the body on many levels.

First of all, this element is involved in the formation of neurotransmitters and neuromodulators and maintains the action potential in the nerve cell. When it is missing, we can be irritated, we become anxious, and - due to the malfunctioning of the nervous system, we can experience muscle tremors, tingling around the mouth, and sleep disturbances.

Some people may also have a feeling of tightness in the chest and a feeling of a lump in their throat. Magnesium deficiency may also increase the risk of osteoporosis and diabetes (hypomagnesia is very common in diabetics) and contribute to the formation of kidney stones and an increased frequency of migraines.

SCFA (short chain fatty acid) deficiency

As a result of inflammation of the large intestine and ulceration, the production of short-chain fatty acids is disturbed, e.g. butyric acid. Butyric acid plays a very important role in the proper absorption of nutrients and protects against endotoxemia, as it ensures the tightness of the intestinal barrier and blocks the penetration of toxins produced by bacteria through it.

It also nourishes the colonocytes, i.e. the cells of the intestineand guarantees their proper functioning, as well as inhibits inflammatory mediators in the intestines, which is extremely important in inflammatory bowel diseases, when you want to put the body into remission.

To increase the production of butyric acid, it is worth providing yourself with products rich in fiber. However, in the period of exacerbation of inflammatory bowel disease, when it is necessary to maintain an easily digestible diet or even parenteral nutrition, the presence of fiber is not recommended. The solution is then butyric acid in the form of a supplement.

During the recovery period, when you can already expand your diet under the supervision of a dietitian, it is worth including, for example, oatmeal in your daily menu, because, according to a study by Hallert and his partners, 60 g of oatmeal administered to patients with UC for 4 weeks resulted in an increase butyrate by 40%.

Products rich in resistant starch also have a beneficial effect on the production of butyrate, so:

  • chilled rice,
  • cold potatoes,
  • or not very ripe bananas.

Zinc deficiency and inflammatory bowel diseases

There is a significant loss of zinc as a result of malabsorption as a consequence of intestinal inflammation and diarrhea. This is disadvantageous as this element plays a very important role in the proper functioning of the immune system.

First of all, it supports the adhesion (sticking) of monocytes (cells of the immune system that fight bacteria, viruses) to the endothelium, which increases the body's immune response.

It is necessary for the proliferation (multiplication) of cells of the immune system, so when the amount of pathogens in the body increases, the amount of zinc automatically decreases (and we should increase it then with the diet or supplements).

In addition, it is part of many enzymes, such as DNA and RNA polymerases; affects the synthesis of hormones, red blood cells and proteins. When it is missing, it affects the condition of the entire body and makes it difficult to bring it into remission.

Inflammatory bowel diseases and folic acid deficiency

The weakening of the bioavailability of vitamin B9, i.e. folic acid, may be influenced by various factors, including inflammation of the intestines, structural changes in the digestive tract, as well as certain medications.

Therefore, in Crohn's disease or UC, there is a deficiency of this vitamin. This is due to leaky gut, inflammation, and taking sulfazalazine or methotrexate.

Folic acid deficiency is associated with the risk of megaloblastic anemia, slower DNA synthesis, as well as slower cell division. Plus, as a resultdisorders of the nervous system caused by a deficiency of folic acid, difficulties in falling asleep, hyperactivity may occur.

There may also be problems with memory, a greater tendency to depression, digestive disorders.

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Gastrology