Crohn's Disease: The Role of Nutrition Support

Donald R. Duerksen, MD, St. Boniface General Hospital and University of Manitoba, Winnipeg, Manitoba, Canada.

In This Article

Micronutrient Deficiencies

In addition to protein calorie malnutrition, patients with Crohn's disease are at risk for developing vitamin and other micronutrient deficiencies. The micronutrient deficiencies that have been described involve the following: vitamins A, D, and E; thiamine; riboflavin; folate; vitamin B12; iron; calcium; magnesium; potassium; and zinc.[46] The etiology of these deficiencies relates to several factors, including decreased oral intake, increased losses (due to underlying diarrhea), and malabsorption (eg, decreased absorption of vitamin B12 in patients with ileal disease or resection).

Because of the prevalence of these deficiencies in patients with Crohn's disease, a high index of suspicion should be maintained. Given this high prevalence, we would recommend that all patients be given a multivitamin/mineral supplement. An anemia due to Crohn's disease may be due to several different deficiencies and therefore requires further investigation. There is an increased incidence of osteoporosis in patients with Crohn's disease (with or without corticosteroid use), and all patients should be assessed to ensure that their calcium and vitamin D intake is normal.


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