Journal
CURRENT OPINION IN GASTROENTEROLOGY
Volume 30, Issue 2, Pages 168-174Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOG.0000000000000037
Keywords
bone mineral density; Crohn's disease; inflammatory bowel disease; osteoporosis; ulcerative colitis
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Funding
- Bingham Chair in Gastroenterology
- Abbott Canada
- Prometheus Laboratories
- Aptalis Pharmaceuticals
- Amgen
- CIHR/Osteoporosis Canada New Investigator Award
- Pfizer Canada (Celebrex)
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Purpose of review To provide a synopsis on established and new research evaluating bone disease in patients with inflammatory bowel disease (IBD). Recent findings Persons with IBD, including Crohn's disease and ulcerative colitis are believed to be at high risk for osteoporosis and fracture. As osteoporosis is clinically silent and persons with IBD are not universally screened, the burden of bone disease in IBD has been difficult to accurately assess. It is also unclear whether bone disease is due to inflammatory activity, medication use, poor nutrient intake/absorption, or body habitus characteristics. Recent studies using population-wide databases of bone mineral density (BMD) analyses suggest that Crohn's disease is responsible for a small effect on BMD after adjusting for other risk factors for low BMD, whereas ulcerative colitis does not appear to confer an independent risk. Furthermore, IBD does not appear to be a risk for overall fracture once controlling for factors which are associated with both IBD and fracture risk. The ability to assess BMD on incidentally performed computed tomography scans may allow detection of low BMD in IBD patients. Summary Although reduced BMD and fracture are more common in persons with IBD, the precise burden is not well characterized. Also, the relative impact of IBD-associated factors and IBD-specific inflammation on bone health is still uncertain.
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