Spontaneous healing of jejunoileal bypass-induced osteomalacia

We have previously reported that osteomalacia may develop in patients relatively soom after jejunoileal (JI) bypass surgery. The present study was designed to determine the course of JI bypass osteomalacia in an untreated group of patients. We performed serial iliac crest biopsies on nine patients at 46 and 79 months (mean) following operation. We found that the amount of osteoid (unmineralized bone matrix) decreased (P less than 0.05) with time, while trabecular bone mass increased (P less than 0.05). Although three patients were osteomalacic at the original biopsy, no patient had evidence of osteomalacia at the second bone biopsy. Based upon these patients, we conclude that the mineralization defect, when it occurs after JI bypass, does not cause clinically significant bone disease and does not persist late postoperatively.