title: Increased risk of osteoporosis-related fractures in patients with irritable bowel syndrome.
abstract: We sought to determine whether patients with irritable bowel syndrome (IBS) have an increased risk of osteoporosis and related fractures using the Nationwide Emergency Department Sample (NEDS). Patients with IBS had increased adjusted odds of osteoporosis and osteoporotic fractures compared to the non-IBS control group, controlling for known risk factors for osteoporosis. Screening measures to identify osteoporosis in this group are advised.
  
  
  BACKGROUND
  Ulcerative colitis, Crohn's disease, and celiac disease have well-described augmented risk of osteoporosis and related fractures. We sought to determine whether IBS also indicates an increased risk of osteoporosis and related fractures.
  
  
  METHODS
  The 2008 NEDS database was used to determine the adjusted odds of osteoporosis and related fractures in IBS patients. Only fractures (pathologic wrist (733.12), vertebrae (733.13), and femur fractures (733.14), traumatic wrist (813.x), vertebrae (805.x-806.x), and hip fractures (820.x-821.x)) with a secondary diagnosis of osteoporosis (733.0x) were included in the analysis. A multivariate logistic regression analysis was performed, controlling for known risk factors for osteoporosis and related fractures.
  
  
  RESULTS
  We identified 317,857 ED visits in patients with a diagnosis of IBS. Of these, 17,752 carried a diagnosis of osteoporosis and 694 IBS patients had a concurrent diagnosis of a pathologic fracture of the wrist, hip, or vertebrae. A total of 1,503 IBS patients had a concurrent diagnosis of a traumatic fracture of the wrist, hip, or vertebra. Overall, patients with IBS had an increased adjusted odds of osteoporosis (odds ratio (OR) 4.28, 95% confidence interval (CI) 4.21-4.35) and osteoporotic fractures (OR 2.36, CI 2.26-2.47) compared to the non-IBS control group. The highest adjusted odds of fracture was seen at the wrist (OR 2.41, CI 2.10-2.77 compared to controls).
  
  
  CONCLUSIONS
  IBS patients are at an increased risk of osteoporosis and related fractures. Screening measures to identify osteoporosis and prevent fractures are advised.
authors.affiliation: Center for the Study of Complex Diseases, Research Institute, Department of Gastroenterology, NorthShore University Health System, 1001 University Place, Evanston, IL 60201, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Stobaugh
authors.forename: P
authors.initials: P
authors.lastname: Deepak
authors.forename: E D
authors.initials: ED
authors.lastname: Ehrenpreis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment / Q000379:methods; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014954:Wrist Injuries / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult