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A Journal on Internal Medicine

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Minerva Medica 2008 February;99(1):65-71

language: English

A 2008 panorama on osteoporosis and inflammatory bowel disease

Sapone N., Pellicano R., Simondi D., Sguazzini C., Reggiani S., Terzi E., Rizzetto M., Astegiano M.

Department of Gastro-Hepatology Molinette Hospital, Turin, Italy


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.

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