The intestinal damage caused by inflammatory bowel disease, or IBD, can interfere with your child's ability to absorb vitamins and other nutrients from food. Nutritional deficiencies in children with ulcerative colitis or Crohn's disease -- the two most common forms of IBD -- can lead to early osteoporosis, delayed growth, weight loss or other health complications. Your child's medical provider may order blood tests to check for nutritional deficiencies and recommend multivitamins or other dietary supplements to make up for lost nutrients.
Causes
IBD affects at least 140,000 people under the age of 18 in the United States, according to 2006 information from the Crohn's and Colitis Foundation of America, or CCFA. Hereditary factors or abnormalities in your child's immune system may contribute to IBD, which leaves inflamed, ulcerated areas in the intestinal lining that absorb many essential vitamins and other minerals from food. IBD can damage certain portions of the digestive tract while leaving other segments of the intestine intact and healthy. Crohn's disease affects the small intestine, which absorbs many of the proteins, carbohydrates, fats, vitamins and minerals your child consumes in food, the CCFA states.
Vitamin A
IBD can interfere with your child's digestion of fats, which absorb fat-soluble vitamins including vitamin A. Vitamin A is found in foods such as liver, eggs and dairy products. The provitamin beta-carotene -- found in orange, yellow and dark green fruits and vegetables -- converts to vitamin A during normal digestion. Vitamin A promotes healthy eyesight, tissue formation and wound healing. In an article published in the Feb. 1998 issue of the "Journal of Pediatric Gastroenterology and Nutrition," Dr. A. Bousvaros and colleagues found that children with Crohn's disease and ulcerative colitis had lower serum levels of vitamin A than children who did not have IBD.
Vitamin B-12 and Folate
Crohn's disease may damage the ileum, a segment of the intestine that absorbs vitamin B-12 and folate. These B-complex vitamins play important roles in nerve function, blood formation and metabolism. B-12 occurs in meat, dairy foods, eggs, fish and fortified cereals. Leafy green vegetables, orange juice, avocados and legumes are rich in folate. Your child's medical provider may recommend vitamin B-complex supplements or a multivitamin to compensate for vitamin B deficiencies.
Vitamin D
Although the foods that your child eats don't cause IBD, certain foods may worsen the abdominal pain, diarrhea, gas, nausea or bleeding associated with the condition. Milk and other dairy products trigger flare-ups of IBD in some children. If your child has trouble digesting milk, he may be at risk for a deficiency in both calcium and vitamin D, an essential vitamin that allows your body to absorb calcium. Your child's skin synthesizes a certain amount of vitamin D through exposure to sunlight. The rest of the vitamin D that your child needs comes from food sources such as milk or cereal fortified with vitamin D, eggs, fish and liver. Dietary vitamin D is absorbed in the small intestine, an area that's susceptible to damage in children with Crohn's disease.
Additional Nutrients
Lactose intolerance and corticosteroid therapy, which is used to treat intestinal inflammation, may interfere with your child's absorption of calcium, a mineral your child needs to form healthy bones. Intestinal bleeding may lead to an iron deficiency. Your child's medical provider may recommend a calcium supplement, a multivitamin with iron or a liquid iron supplement to replenish these nutrients.
References
- Crohn's and Colitis Foundation of America: Diet and Nutrition
- Crohn's and Colitis Foundation of America: Guide for Kids and Teens
- Children's Digestive Health and Nutrition Foundation: IBD Nutrition Guide
- PubMed.gov: Vitamins A and E Serum Levels in Children and Young Adults with Inflammatory Bowel Disease: Effect of Disease Activity
- University of Maryland Medical Center: Vitamins -- Introduction
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