The Effect of Bowel Disease on Nutritional Status

Your intestines play a VERY important role in the digestion and absorption of nutrients. Disease, inflammation, or infection ANYWHERE in the digestive tract can set the stage for poor absorption of nutrients and therefore deficiency. Nutrient deficiency is a risk factor for chronic disease. Below are diseases of the intestines that can impact nutrient status.

Inflammatory Bowel Disease

Individuals with inflammatory bowel disease (IBD) and, particularly, those with Crohn’s disease are at risk for a variety of nutritional deficiencies because of decreased nutrient intake or absorption and/or increased losses. In adults, the most common problems are deficiencies of micronutrients, including several water-soluble and fat-soluble vitamins and minerals like calcium, iron, B vitamins and other trace minerals.

A combination of factors contributes to nutrient deficits in IBD. Reduced nutrient intake is common. Malabsorption, maldigestion, increased energy expenditure, and gastrointestinal protein loss also contribute and are usually correlated with disease activity.

In addition, because some nutrients are digested and absorbed within specific locations within the gastrointestinal tract, the activity and location of a patient’s intestinal disease determines risk for specific micronutrient deficiencies. As examples, patients with disease of the terminal ileum are at risk for vitamin B12 deficiency, and those with disease of the proximal small intestine are more likely to malabsorb calcium and iron. Research suggests that less active disease, as in remission, equates to less malabsorption. The goal, then, would be to obtain remission in those with IBD to prevent deficiency.

GI Disorders

Other GI disorders like small intestinal bacterial overgrowth (SIBO), infections, yeast or parasites can create intestinal inflammation in different areas of the intestine during the digestion process. This inflammation leads to poor nutrient absorption and therefore deficiency. Fixing the root cause of these disorders can increase absorption and reverse deficiency.

Atropic Gastritis

About 10-30% of Americans over the age of 50 suffer from a condition called atrophic gastritis, which severely restricts nutrient intake.


Low stomach acid, or hypoclorhydria, is a condition in which the production of hydrochloric acid in the stomach is absent or low. This condition causes the malabsorption of many vitamins and minerals like vitamin D, B vitamins, iron, magnesium, and essential fatty acids. This condition can be induced with medications that block stomach acid, in protein deficient diets, and by infection by H Pylori. Treatment includes adding stomach acid back in through supplementation and encouraging the body to begin making more again.

Pancreatic Insufficiency

Pancreatic enzymes are needed to breakdown food into useable parts. Deficiency in these enzymes can prevent proper breakdown of foods and the absorption of adequate amounts of nutrients. Supplementing with pancreatic enzymes can help to increase absorption and prevent deficiency.