A 2008 panorama on osteoporosis and inflammatory bowel disease.
The availability of osteodensitometry has contributed significantly to increase the awareness of inflammatory bowel disease (IBD)-associated bone disease. Reported osteoporosis prevalence in patients with IBD range from 2% to 30%. The fractures risk varies between studies, influenced by demographic, clinical and genetic factors. The main pathogenetic factors involved are malabsorption, treatment with glucocorticoids, inflammation (increased cytokine production) and hypogonadism. A screening should be considered for all patients with small bowel Crohn's disease and especially for those with extensive disease, multiple resections, and malnutrition. Supplementation with both calcium and vitamin D is frequently the first step taken, but is insufficient to inhibit bone loss in many patients requiring use of glucocorticoids. Among available therapies, only biphosphonates are effective for treatment of glucocorticoid-induced osteoporosis.
Sapone
N
N
Department of Gastro-Hepatology, Molinette Hospital, Turin, Italy.
Pellicano
R
R
Simondi
D
D
Sguazzini
C
C
Reggiani
S
S
Terzi
E
E
Rizzetto
M
M
Astegiano
M
M
D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007006:Hypogonadism / Q000150:complications; D007249:Inflammation / Q000150:complications; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008286:Malabsorption Syndromes / Q000150:complications; D010024:Osteoporosis / Q000209:etiology* / Q000517:prevention & control
D005938:Glucocorticoids