Surgical approach in patients with IBD such as end ileostomy imposes additional metabolic consequences to an already burdened population. In IBD patients with ileostomy, our group has previously shown a high prevalence of low bone mineral density, further complicated by increased risk of fractures. There may be an increased risk of vitamin B12 deficiency in these patients, although this seems to be more common when significant amounts of ileum are resected.
In addition, there is an increased fecal excretion of cholesterol and bile acids in patients with ileostomy, which has been shown to improve cholesterol profile in these patients, while it my further impair bile acid enterocirculation. the association between vitamin D deficiency and anemia, on the other hand, has not been established in this population.