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Osteoporosis in Gastrointestinal Diseases
Iwona Krela-Kaźmierczak1, Aleksandra Szymczak1, Liliana Łykowska-Szuber1
1Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poland.
Summary
Secondary osteoporosis, often seen in young patients with gastrointestinal diseases, requires early diagnosis and management to prevent fractures. This condition necessitates specific screening and treatment algorithms, especially for premenopausal women and young men.
Area of Science:
- Endocrinology and Metabolism
- Gastroenterology
- Bone Health
Background:
- Secondary osteoporosis can occur independently or alongside primary osteoporosis types I and II.
- Gastroenterologists frequently encounter osteoporosis or osteopenia in patients with gastrointestinal disorders.
- Early intervention is crucial in young patients to prevent fractures and optimize peak bone mass.
Purpose of the Study:
- To highlight the association between gastrointestinal diseases and secondary osteoporosis.
- To emphasize the need for risk factor identification and screening for osteoporosis in affected patients.
- To advocate for a distinct therapeutic management algorithm for secondary osteoporosis in gastrointestinal disease patients, particularly young individuals.
Main Methods:
- Review of conditions associated with secondary osteoporosis, including Crohn's disease, ulcerative colitis, celiac disease, post-gastrectomy status, short bowel syndrome, chronic hepatitis, cirrhosis, steroid use, and chronic proton pump inhibitor use.
- Identification of risk factors indicating the need for osteoporosis screening.
- Recommendation for Dual-energy X-ray absorptiometry (DXA) studies.
Main Results:
- Osteoporosis is linked to various gastrointestinal conditions and treatments.
- Specific patient groups, such as those with Crohn's disease, ulcerative colitis, celiac disease, post-gastrectomy, short bowel syndrome, chronic liver disease, steroid therapy, and chronic PPI use, are at risk.
- There is a lack of registered drugs with proven antifracture efficacy for young patients with secondary osteoporosis.
Conclusions:
- A defined list of risk factors for secondary osteoporosis in gastrointestinal disease patients should be established.
- Screening protocols, including DXA scans, are necessary for at-risk individuals.
- A specialized treatment algorithm is required for secondary osteoporosis associated with gastrointestinal diseases, especially in premenopausal women and young men.
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