Vitamin D deficiencies have been linked to an increased risk of inflammatory bowel disease. Inflammatory bowel disease is a name given to a group of chronic digestive diseases of the small and large intestines, including colitis, proctitis, enteritis and ileitis. Typically, doctors divide IBD into two groups: ulcerative colitis and Crohn’s disease.

Ulcerative colitis causes ulcers and inflammation of the lining of the colon (large intestine). It almost always involves the rectum and usually causes a bloody diarrhea.

Crohn’s disease is an inflammation that extends into the deeper layers of the intestinal wall. In about 30 percent of cases the disease is limited to one or more segments of the small intestine, usually the ileum (ileitis); about 50 percent of the time it involves both the ileum and the colon (ileocolitis); and 20 percent of the time it is confined to the colon (Crohn’s colitis). Inflammation may also affect the mouth, esophagus, stomach, duodenum, appendix or anus.

Ulcerative colitis and Crohn’s disease are chronic conditions that may recur over a lifetime. Many people have long periods – sometimes years – when they are symptom-free. Unfortunately, doctors cannot predict with certainty when the disease will go into remission or when the symptoms will return.

There is good news for southerners, however.

In the study, a group of Boston researchers followed nearly 120,000 female nurses over a 20-year period. At the study’s inception none of the participants had inflammatory bowel disease. Over the course of the study, 284 participants developed Crohn’s disease and 332 developed ulcerative colitis.

Women who lived in southern latitudes at age 30 were about 50 percent less likely to have Crohn’s disease and about one-third less likely to have ulcerative colitis than those who lived in the north. Those born in the South or living in the South at age 15 also fared better, but the findings for that group were not as significant. Sunanda Kane, MD, a gastroenterologist with the Mayo Clinic in Rochester, Minn., said there is no reason to believe the findings would not also apply to men.

Researchers are working to determine cause and effect, and studies are underway to look at whether or not vitamin D supplements will help relieve symptoms of Crohn’s disease. In the meantime, southern women can bask in the knowledge that they have a reduced risk of inflammatory bowel disease.

Most people are diagnosed with Crohn’s at around age 20-30, although it can occur at any age. It also is more common in Caucasians, people with a family history of the disease and people who smoke. Cigarette smoking is the most controllable risk factor for developing the disease. Smoking also worsens symptoms and increases the likelihood that a patient will eventually need to have surgery.

Typical symptoms of Crohn’s include persistent diarrhea (which may be bloody), cramping, abdominal pain, fever, loss of appetite and weight loss.

A colonoscopy is usually required to make a diagnosis of Crohn’s.  Other helpful tests often used in the evaluation include blood tests, stool samples, abdomen x-ray or CAT scan, and video capsule endoscopy (Pillcam).   A colonoscopy involves a sedated examination of the entire colon with a flexible, lighted tube with an attached camera. The procedure also provides an opportunity for your doctor to take small tissue samples for laboratory analysis, which may help confirm a diagnosis.

There is no known cure for Crohn’s, although symptoms can be treated with drugs and sometimes surgery. The disease may also go into remission for years at a time.

Living with Crohn’s can be difficult, but patients can help manage the problem of chronic diarrhea by diet and lifestyle changes. If you have Crohn’s, following these tips may lessen your symptoms:

• Take the medications recommended by your gastroenterologist.
• Limit dairy products.
• Eat low-fat foods.
• Avoid gas-producing foods like beans, cabbage and broccoli.
• Limit your intake of raw fruit juices and fruits (especially citrus fruits), spicy food, popcorn, alcohol and caffeinated beverages.
• Eat several small meals throughout the day.
• Drink lots of liquids.
• Avoid stressful situations.
• Reduce stress by exercising, meditating and/or following relaxation techniques.
• If you smoke, quit

If you are experiencing the symptoms of Crohn’s disease and are concerned that you may have the disease, see your doctor.

Symptoms of IBS include diarrhea, constipation, abdominal cramps and bloating. For some people, symptoms are mild; many don’t even seek treatment for the condition. For others it can be very distressing and make it difficult to carry on normal daily activities.

Though the specific cause is unknown, many attribute the condition to stress. It is not unusual for people to respond to stress with some sort of physical reaction, often centering in the gastrointestinal system. With IBS, the muscles of the intestines don’t move as they should. And this “gut” reaction to stress can be annoying, uncomfortable and even painful.

When someone complains of these symptoms, the first thing we do is rule out other underlying causes such as Crohn’s disease, ulcerative colitis or cancers of the colon. The absence of another disease can indicate that the problem is IBS.

The most important thing to remember is that though it can be uncomfortable, it is definitely not serious and does not lead to more dangerous diseases. Even so, the symptoms should not be ignored. While there is no precise cure for IBS, a modified diet, lifestyle changes and medications can alleviate the pain and discomfort and help those with the condition lead a more normal life.

Dietary changes can be effective, especially when specific foods that provoke the symptoms are eliminated. For example, increasing dietary fiber and avoiding items that stimulate the intestines such as caffeine may stop chronic diarrhea. Lifestyle changes including regular exercise and improved sleep have also been shown to reduce anxiety and relieve symptoms.

When diet and lifestyle changes produce no improvement, there are some medications such as smooth (intestinal) muscle relaxers and low-dose antidepressants that may help relieve intestinal pain.

There is no single solution for IBS, since the condition affects each person differently. And there is no surgical remedy.

However, there’s no need to live with chronic diarrhea, constipation and pain. Consult a physician and see what you can do to help you get your intestinal tract back on track.