Chronic functional constipation is strongly linked to vitamin D deficiency

World J Gastroenterol. 2019 Apr 14;25(14):1729-1740. doi: 10.3748/wjg.v25.i14.1729.

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.

Keywords: Anxiety; Chronic constipation; Depression; Intestinal motility; Quality of life; Vitamin D.

MeSH terms

  • Adult
  • Aged
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Anxiety / psychology
  • Case-Control Studies
  • Chronic Disease / epidemiology
  • Chronic Disease / psychology
  • Constipation / epidemiology
  • Constipation / etiology*
  • Constipation / physiopathology
  • Constipation / psychology
  • Depression / epidemiology
  • Depression / etiology
  • Depression / psychology
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / physiopathology
  • Gastrointestinal Diseases / psychology
  • Gastrointestinal Transit / physiology*
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Quality of Life*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*

Substances

  • Vitamin D
  • 25-hydroxyvitamin D