***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Importance Irritable bowel syndrome ( IBS ) is associated with significant morbidity in children and adolescents , and the therapeutic efficacy of available treatment options is limited . The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown . Equally , the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear . Aim To characterize the vitamin D status of pediatric patients with IBS using a case-control study design . Hypothesis Serum 25-hydroxyvitamin D [ 25(OH)D ] concentration will be similar between patients with IBS and controls . Subjects and methods A retrospective case-controlled study of 116 controls ( age 14.6 ± 4.3 y ) , female ( n = 67 ; 58 % ) and 55 subjects with IBS ( age 16.5 ± 3.1y ) , female ( n = 44 ; 80 % ) . Overweight was defined as BMI of ≥85th but < 95th percentile , and obesity as BMI ≥95th percentile . Vitamin D deficiency was defined as 25(OH)D of < 50 nmol/L , while seasons of vitamin D draw were categorized as summer , winter , spring , and fall . Major psychosomatic manifestations included in the analysis were depression , anxiety , and migraine . Results More than 50 % of IBS subjects had vitamin D deficiency at a cut-off point of < 50 nmol/L ( 53 % vs. 27 % , p = 0.001 ) ; and > 90 % of IBS subjects had vitamin D deficiency at a cut-off point of < 75 nmol/L ( 93 % vs. 75 % , p = 0.006 ) . IBS subjects had significantly lower mean 25(OH)D : 53.2 ± 15.8 nmol/L vs. 65.2 ± 28.0 nmol/L , p = 0.003 ; and albumin : 6.2 ± 0.6 vs. 6.5 ± 0.6 μmol/L , p = 0.0.01 . IBS subjects with migraine had significantly lower mean 25(OH)D concentration compared to controls ( p = 0.01 ) . BMI z-score was similar between the controls and IBS subjects ( 0.5 ± 1.4 vs. 1.2 ± 2.9 , p = 0.11 ) . Conclusions Pediatric patients with IBS had significantly lower 25(OH)D concentration compared to controls despite having similar mean BMI values as controls . Only 7 % of the children and adolescents with IBS were vitamin D sufficient , and > 50 % of the subjects with IBS had vitamin D deficiency . This is a much higher prevalence of vitamin D deficiency compared to IBD and other malabsorption syndromes . Monitoring for vitamin D deficiency should be part of the routine care for patients with IBS . R and omized control trials are warranted to determine the role of adjunctive vitamin D therapy in pediatric IBS Background / Aim : Vitamin D deficiency is common in irritable bowel syndrome ( IBS ) . There is growing interest in the role of vitamin D in pediatric IBS . We aim ed to evaluate the effect of vitamin D supplementation in adolescents with IBS and vitamin D deficiency . Patients and Methods : One hundred and twelve adolescents with IBS and vitamin D deficiency were r and omly divided into two groups of matched age and sex . The first group received oral vitamin D3 2000IU/day for 6 months and the second group received placebo for 6 months . Vitamin D status as well as different IBS score systems ( IBS-SSS , IBS-QoL , and total score ) were evaluated before and 6 months after treatment . Results : IBS patients who received vitamin D supplementation for 6 months showed significant improvement in IBS-SSS ( P < 0.001 ) , IBS-QoL ( P < 0.001 ) , and total score ( P = 0.02 ) compared to IBS placebo group . IBS patients treated with vitamin D showed two folds increase in their serum vitamin D levels ( from 17.2 ± 1.3 to 39 ± 3.3 ) ng/ml with P < 0.001 . While in the placebo group , their serum vitamin D levels were not significantly changed ( P = 0.66 ) . Vitamin D was tolerated well without any recorded adverse effects during the study period . Conclusion : Vitamin D supplementation can be effective in treating adolescents with IBS and vitamin D deficiency Background Vitamin D deficiency has been associated or implicated with the pathophysiology of the gastrointestinal conditions inflammatory bowel disease and colorectal cancer , as well as with depression . No trials or epidemiology studies to date have investigated a link with irritable bowel syndrome ( IBS ) . A single case report has suggested a benefit in IBS of vitamin D supplementation . We hypothesised that IBS participants with vitamin D insufficiency would benefit from repletion in terms of their IBS symptoms . We undertook a pilot trial to provide data to support a power calculation and to justify a full trial . Methods This was a r and omised , double blinded , three-arm parallel design trial of vitamin D , placebo or a combination of vitamin D and probiotics .  Participants were further stratified according to whether they were vitamin D replete or insufficient . Vitamin D status was determined by blood test at baseline and exit ; IBS symptoms were assessed by vali date d question naire ; dietary intakes were assessed by food frequency question naire . Results A significant proportion of the IBS population were vitamin D deficient , such that the replete stratum could not be adequately recruited . There was a significant association in the baseline data between circulating vitamin D level and quality of life ( “ How much has IBS affected your life ? ” ) . Supplementation significantly improved vitamin D level  versus placebo .  IBS symptoms were not significantly improved in this pilot , although a power calculation was enabled from the intervention data . Conclusions The IBS population exhibits significant levels of vitamin D insufficiency and would benefit from screening and possible supplementation . The impact of IBS on quality of life may be reduced by vitamin D level . Future trials should have a sample size of over 97 . Trial registration number : ICTRN 6116003917 Background Low vitamin D status is associated with risk of colorectal cancer and has been implicated in inflammatory bowel disease . Irritable bowel syndrome ( IBS ) is a chronic , relapsing , functional bowel disorder . A nascent literature suggests a role for vitamin D in IBS , but this has not been collated or critiqued . To date , seven studies have been published : four observational studies and three r and omised controlled trials ( RCTs ) . All observational studies reported that a substantial proportion of the IBS population was vitamin D deficient . Two intervention studies reported improvement in IBS symptom severity scores and quality of life ( QoL ) with vitamin D supplementation . There are limited data around the role of vitamin D in IBS . Conclusions The available evidence suggests that low vitamin D status is common among the IBS population and merits assessment and rectification for general health reasons alone . An inverse correlation between serum vitamin D and IBS symptom severity is suggested and vitamin D interventions may benefit symptoms . However , the available RCTs do not provide strong , generalisable evidence ; larger and adequately powered interventions are needed to establish a case for therapeutic application of vitamin D in IBS BACKGROUND Low- grade mucosal inflammation and immune activation are involved in the pathogenesis of irritable bowel syndrome ( IBS ) . Furthermore , IBS symptoms are associated with a significantly higher prevalence of psychological distress , which in itself results into an impaired quality of life ( QoL ) . Vitamin D could ameliorate the symptoms of patients suffering from IBS through its beneficial effects on psychological factors and inflammation . METHODS A total of 90 IBS patients participated in this double-blind , r and omized , placebo-controlled study . Participants were r and omly selected to receive either 50 000 IU vitamin D3 or a placebo fortnightly for a period of 6 months . Patients reported their IBS symptoms at the baseline and monthly during intervention periods . The IBS severity score system ( IBSSS ) and IBS-specific QoL question naires were used at the baseline and postintervention . KEY RESULTS Over the 6-month intervention period , a significantly greater improvement in IBS symptoms such as abdominal pain and distention , flatulence , rumbling , and overall gastrointestinal ( GI ) symptoms ( except dissatisfaction with bowel habits ) was observed in the patients receiving vitamin D as compared to the placebo group . The IBSSS and the IBS-QoL scores in the vitamin D group significantly improved compared to the placebo group postintervention ( mean IBSSS score change : -53.82 ± 23.3 vs -16.85 ± 25.01 , p < 0.001 , respectively ; mean IBS-QoL score change : 14.26 ± 3 vs 11 ± 2.34 , p < 0.001 , respectively ) . CONCLUSIONS & INFERENCES Vitamin D seems to be an effective and safe option to improve QoL and symptoms of IBS . Clinical Trials.gov ( NCT02579902 ) 
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Conclusions : The findings of this systematic review may provide the existing evidence on the effectiveness and safety of VD for patients with IBS .