American Journal of Clinical Nutrition, Vol 54, 548-552, Copyright © 1991 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn's disease and intestinal resection

GA Leichtmann, JM Bengoa, MJ Bolt and MD Sitrin
Department of Medicine, University of Chicago, IL.

We compared the intestinal absorption of cholecalciferol and 25- hydroxycholecalciferol in patients with Crohn's disease and resections of the small bowel. Patients were subgrouped into those with small (less than 100 cm), intermediate (100-300 cm), and large (greater than 300 cm) resections. [3H]cholecalciferol or [3H]25- hydroxycholecalciferol were given orally and serial blood samples were taken for measurement of plasma radiolabeled vitamin. Absorption of both forms of the vitamin decreased with extent of resection but 25- hydroxycholecalciferol absorption was always greater than that of cholecalciferol. When compared with normal control subjects, 25- hydroxycholecalciferol absorption in these patients was better maintained than that of cholecalciferol. These data indicate that vitamin D malabsorption reflects the extent of distal small-bowel resection in Crohn's disease. Treatment with oral cholecalciferol is sufficient in those with small or moderate resections but oral 25- hydroxycholecalciferol supplementation may be preferred in those with a severe short-bowel syndrome.

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