As the main system for the ingestion and absorption of foodstuffs, the gastrointestinal tract occupies a prominent position in the causation of vitamin deficiencies. Thus it has been pointed out that "any pathologic condition which interferes with normal food intake, normal digestion, normal absorption of the products of digestion, and normal utilization of these products by the liver, may produce secondary or conditioned avitaminosis."1 In addition, the gastrointestinal tract is one of the first systems to present objective clinical signs when deficiencies of certain vitamins occur.
An examination of the diets usually prescribed for patients with peptic ulcer, colitis and disease of the gallbladder shows that they often consist mainly of refined carbohydrate and are apt to be deficient in one or more of the vitamins. Patients with idiosyncrasies regarding food expressed in the diet they select will more often than not favor refined foods low in vitamins. On the
ROSENBLUM LA, JOLLIFFE N. THE ORAL MANIFESTATIONS OF VITAMIN DEFICIENCIES. JAMA. 1941;117(26):2245–2248. doi:10.1001/jama.1941.02820520041011
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