Folate deficiency in chronic inflammatory bowel diseases

Area of Science:

• Gastroenterology
• Hematology
• Nutritional Science

Background:

• Chronic inflammatory bowel diseases (CIBD) encompass conditions like Crohn's disease and ulcerative colitis.
• Nutritional deficiencies, particularly folate, are frequently observed in CIBD patients.
• Understanding the causes and consequences of folate deficiency is crucial for managing CIBD.

Purpose of the Study:

• To investigate the prevalence and potential causes of folate deficiency in outpatients with CIBD.
• To assess the relationship between folate levels, folate intake, absorption, and medication use (salazosulphapyridine).
• To evaluate the hematological impact of folate deficiency in this patient group.

Main Methods:

• Consecutive study of 216 CIBD outpatients.
• Measurement of serum and erythrocyte folate levels.
• Bone marrow examination for megaloblastic changes.
• Folate intake assessment and absorption studies using tritiated folate.
• Reticulocyte count and 51Cr erythrocyte survival time analysis.

Main Results:

• Low serum and erythrocyte folate levels were found in 59% and 26% of patients, respectively.
• Megaloblastic changes were present in 67% of patients with low folate in both serum and erythrocytes.
• 23% of patients with low folate exhibited poor folate absorption, independent of salazosulphapyridine use.
• Elevated reticulocyte counts and decreased erythrocyte survival were noted in folate-deficient patients.

Conclusions:

• Folate deficiency in CIBD appears multifactorial, involving inadequate dietary intake, malabsorption, and chronic drug-induced hemolysis.
• The findings suggest a significant hematological impact associated with folate deficiency in CIBD.
• Further evaluation is needed to determine the clinical significance of these findings in CIBD management.