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International Urogynecology Journal

Published in:

01-11-2014 | Original Article

Vitamin D deficiency is associated with increased fecal incontinence symptoms

Authors: Candace Y. Parker-Autry, Jonathan L. Gleason, Russell L. Griffin, Alayne D. Markland, Holly E. Richter

Published in: International Urogynecology Journal | Issue 11/2014

Abstract

Introduction and hypothesis

Vitamin D is an important micronutrient in muscle function. We hypothesize that vitamin D deficiency may contribute to fecal incontinence (FI) symptoms by affecting the anal continence mechanism. Our goal was to characterize the association of vitamin D deficiency as a variable affecting FI symptoms and its impact on health-related quality of life (HR-QoL).

Methods

This case–control study assessed women seen at a tertiary-care referral center. Participants were identified as having had a serum vitamin D level obtained within a year of their visit: cases were women presenting for care for FI symptoms; controls were women without any pelvic floor symptoms presenting to the same clinical site for general gynecologic care. Cases completed the Modified Manchester Health Questionnaire (MMHQ) and the Fecal Incontinence Severity Index to measure symptom severity and burden on QoL.

Results

Among the 31 cases and 81 controls, no demographic or medical differences existed. Women with FI had lower vitamin D levels (mean 29.2 ± 12.3 cases vs. 35 ± 14.1 ng/ml controls p = 0.04). The odds of vitamin D deficiency were higher in women with FI compared with controls [odds ratio (OR) 2.77, 95 % confidence interval (CI) 1.08–7.09]. Among cases, women with vitamin D deficiency (35 %) had higher MMHQ scores, indicating greater FI symptom burden [51.3 ± 29.3 (vitamin D deficient) vs. 30 ± 19.5 (vitamin D sufficiency), p = 0.02]. No differences were noted for FI severity, p = 0.07.

Conclusions

Vitamin D deficiency is prevalent in women with fecal incontinence and may contribute to patient symptom burden.

Nygaard I, Barber MD, Burgio KL et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300(11):1311–1316PubMedCrossRefPubMedCentral

Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21(1):5–26PubMedCrossRef

Hull TL, Zutshi M (2007) Fecal incontinence. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery, 3rd edn. Mosby Elsevier, Philadelphia, pp 309–320CrossRef

Ward KA, Das G, Roberts SA et al (2010) A randomized, controlled trial of vitamin D supplementation upon musculoskeletal health in postmenarchal females. J Clin Endocrinol Metab 95(10):4643–4651PubMedCrossRef

Zhu K, Austin N, Devine A, Bruce D, Prince RL (2010) A randomized controlled trial of the effects of vitamin D on muscle strength and mobility in older women with vitamin D insufficiency. J Am Geriatr Soc 58(11):2063–2068PubMedCrossRef

Yetley EA (2008) Assessing the vitamin D status of the US population. Am J Clin Nutr 88(2):558s–564sPubMed

Mithal A, Wahl DA, Bonjour JP et al (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int J Established Result Cooperation Between Eur Found Osteoporos Natl Osteoporos Found USA 20(11):1807–1820CrossRef

Badalian SS, Rosenbaum PF (2010) Vitamin D and pelvic floor disorders in women: results from the National Health and Nutrition Examination Survey. Obstet Gynecol 115(4):795–803PubMedCrossRef

Mitchell DM, Henao MP, Finkelstein JS, Burnett-Bowie SA (2012) Prevalence and predictors of vitamin D deficiency in healthy adults. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinologists 18(6):914–923

10.

Wang S (2009) Epidemiology of vitamin D in health and disease. Nutr Res Rev 22(2):188–203PubMedCrossRef

11.

Pittas AG, Chung M, Trikalinos T et al (2010) Systematic review: vitamin D and cardiometabolic outcomes. Ann Intern Med 152(5):307–314PubMedCrossRefPubMedCentral

12.

Allan K, Devereux G (2011) Diet and asthma: nutrition implications from prevention to treatment. J Am Diet Assoc 111(2):258–268PubMedCrossRef

13.

Shand AW, Nassar N, Von Dadelszen P, Innis SM, Green TJ (2010) Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre-eclampsia. BJOG Int J Obstet Gynaecol 117(13):1593–1598CrossRef

14.

Moyer VA (2013) Vitamin D and calcium supplementation to prevent fractures in adults: U.s. preventive services task force recommendation statement. Ann Intern Med 158(9):691–696PubMed

15.

Bischoff-Ferrari HA, Borchers M, Gudat F, Durmuller U, Stahelin HB, Dick W (2004) Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res Off J Am Soc Bone Miner Res 19(2):265–269CrossRef

16.

Holick MF, Chen TC, Lu Z, Sauter E (2007) Vitamin D and skin physiology: a D-lightful story. J Bone Miner Res Off J Am Soc Bone Miner Res 22(Suppl 2):V28–V33CrossRef

17.

Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res Off J Am Soc Bone Miner Res 18(2):343–351CrossRef

18.

Lips P, Binkley N, Pfeifer M et al (2010) Once-weekly dose of 8400 IU vitamin D(3) compared with placebo: effects on neuromuscular function and tolerability in older adults with vitamin D insufficiency. Am J Clin Nutr 91(4):985–991PubMedCrossRef

19.

Dhesi JK, Jackson SH, Bearne LM et al (2004) Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 33(6):589–595PubMedCrossRef

20.

Parker-Autry CY, Markland AD, Ballard AC, Downs-Gunn D, Richter HE (2012) Vitamin D status in women with pelvic floor disorder symptoms. Int Urogynecol J 23(12):1699–1705PubMedCrossRefPubMedCentral

21.

Zerwekh JE (2008) Blood biomarkers of vitamin D status. Am J Clin Nutr 87(4):1087s–1091sPubMed

22.

Ubesie AC, Heubi JE, Kocoshis SA et al (2013) Vitamin D deficiency and low bone mineral density in pediatric and young adult intestinal failure. J Pediatr Gastroenterol Nutr 57(3):372–376PubMedCrossRefPubMedCentral

23.

Kwon S, Visco AG, Fitzgerald MP, Ye W, Whitehead WE, Pelvic Floor Disorders N (2005) Validity and reliability of the Modified Manchester Health Questionnaire in assessing patients with fecal incontinence. Dis Colon Rectum 48(2):323–331, discussion 331–324PubMedCrossRef

24.

Alkhatib AA, Tuteja AK (2010) High prevalence of vitamin D deficiency among patients with fecal incontinence. Dig Dis Sci 55(12):3632–3633PubMedCrossRef

25.

Bischoff HA, Borchers M, Gudat F et al (2001) In situ detection of 1,25-dihydroxyvitamin D3 receptor in human skeletal muscle tissue. Histochem J 33(1):19–24PubMedCrossRef

26.

Brown HW, Wexner SD, Lukacz ES (2013) Factors associated with care seeking among women with accidental bowel leakage. Female Pelvic Med Reconstr Surg 19(2):66–71PubMedCrossRef

Title: Vitamin D deficiency is associated with increased fecal incontinence symptoms
Authors: Candace Y. Parker-Autry
Jonathan L. Gleason
Russell L. Griffin
Alayne D. Markland
Holly E. Richter
Publication date: 01-11-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 11/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-014-2389-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Vitamin D deficiency is associated with increased fecal incontinence symptoms

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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