Vitamin D supplementation in people with IBS has no effect on symptom severity and quality of life: results of a randomised controlled trial

Claire E Williams,Elizabeth A Williams,Bernard M Corfe

doi:10.1007/s00394-021-02633-w

Claire E Williams, Elizabeth A Williams + Show 1 more

Open Access

https://doi.org/10.1007/s00394-021-02633-w

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Abstract

PurposeSeveral small trials suggest a benefit of vitamin D supplementation in irritable bowel syndrome (IBS). The generalisability of these reports is limited by their design and scale. This study aimed to assess whether vitamin D supplementation improved IBS symptoms in a UK community setting.MethodsThis was a randomised, double-blind, placebo-controlled study. Participants were recruited from the community in winter months between December 2017 and March 2019. 135 participants received either vitamin D (3,000 IU p.d.) or placebo for 12 weeks. The primary outcome measure was change in IBS symptom severity; secondary outcomes included change in IBS-related quality of life.ResultsThe participants were analysed on an intent-to-treat basis. 60% of participants were vitamin D deficient or insufficient at baseline. Although vitamin D levels increased in the intervention arm relative to placebo (45.1 ± 32.88 nmol/L vs 3.1 ± 26.15 nmol/L; p < 0.001). There was no difference in the change of IBS symptom severity between the active and placebo trial arms (− 62.5 ± 91.57 vs – 75.2 ± 84.35, p = 0.426) over time. Similarly there was no difference between trial arms in τhe change in quality of life (− 7.7 ± 25.36 vs – 11.31 ± 25.02, p = 0.427).ConclusionsThere is no case for advocating use of vitamin D in the management of IBS symptoms. The prevalence of vitamin D insufficiency suggests routine screening and supplementation should be implemented in this population for general health reasons.This trial was retrospectively registered with ISRCTN (ISRCTN13277340) on 24th April 2018 after recruiting had been initiated.

Highlights

Irritable Bowel Syndrome (IBS) is a highly prevalent functional bowel disorder, with estimates of numbers affected in westernised populations ranging widely, but often in the region of 10–15%[1], this estimate has been revised to under 5% [2] with the introduction of revised ROME IV criteria for assessment [3]
This study sought to investigate the potential of vitamin D supplementation as a management strategy for IBS, the design was community-based, seeking to be applicable to the general IBS population in addition to clinical settings
This study found no benefit of vitamin D supplementation on either symptoms of IBS or on QoL measures using standardised assessments

Summary

Introduction

Irritable Bowel Syndrome (IBS) is a highly prevalent functional bowel disorder, with estimates of numbers affected in westernised populations ranging widely, but often in the region of 10–15%[1], this estimate has been revised to under 5% [2] with the introduction of revised ROME IV criteria for assessment [3]. It is characterised by chronically relapsing perturbed bowel habit, associated pain and sensitivity, and dissatisfaction with bowel movements[4]. The nature and impact of symptoms, coupled to lack of a clear treatment path, have associated impacts on mental health and well-being[13]

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