VITAMIN B12 IN CROHN'S DISEASE AND ULCERATIVE COLITIS

Vitamin B12 is an essential nutrient that can be lacking in those with inflammatory bowel disease (IBD).

The functions of vitamin B12 include:

• help form red blood cells
• transmit nerve signals
• manufacture DNA
• energy production

Since our bodies cannot make vitamin B12, it is important that we get enough in our diets and are able to properly absorb it. If your child has Crohn's Disease (a Crohnie) or ulcerative colitis ( a UCee),  they may not be absorbing enough B12 which can put them at risk for a deficiency.

Dietary sources of B12:

•  Animal products: meat, poultry, eggs, dairy, some cheeses 
• Fortified foods: cereal, some breakfast foods, some non-dairy milk, some nutritional yeast
• Supplement: multivitamin, B12 vitamin

Absorption and IBD

Before Vitamin B12 reaches the small intestine, it must first mix with our stomach acid before it can be absorbed into the cells of the small intestine. However, in some cases of IBD, your child may be on acid blockers (like Prilosec, Prevacid, Nexium, etc)  to help combat stomach ulcers or acid reflux. If this is the case, there may not be enough stomach acid to mix with vitamin B12. That could reduce its ability to be absorbed when it gets to the small intestine. Overtime, this can lead to a B12 deficiency.

Absorption and Crohn's Disease

Vitamin B12 is absorbed in the small intestine. In Crohn's Disease, the small intestine can be heavily inflamed which can reduce absorption of many nutrients, including vitamin B12. In severe cases, parts of the small intestine such as the terminal ileum may be removed in surgery which can put a Crohnie at a greater risk for malabsorption.

Absorption and Ulcerative Colitis  

For UCees, B12 absorption issues are not as common unless they have a condition called backwash ileitis. Backwash Ileitis causes inflammation in the terminal ileum of the small intestine. If you or child has this, B12 absorption will be reduced. Additionally, if they have parts of the inflamed terminal ileum removed, the risk for malabsorption is increased. Eventually this can lead to a UCee being deficient in B12 .

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