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Metabolic bone diseases in intestinal failure.
1Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
Summary
Metabolic bone diseases are common in intestinal failure patients due to underlying conditions, nutrient malabsorption, and historical parenteral nutrition contamination. This review covers diagnosis and management of bone health in these patients.
Area of Science:
- Bone Metabolism
- Gastroenterology
- Nutritional Science
Background:
- Metabolic bone diseases are frequent complications in patients with intestinal failure.
- Underlying conditions (e.g., Crohn's disease) and treatments (e.g., corticosteroids) contribute to bone disease.
- Nutrient malabsorption (e.g., Vitamin D) and historical parenteral nutrition aluminum contamination exacerbate bone metabolism issues.
Purpose of the Study:
- To review the diagnosis of metabolic bone diseases in patients with intestinal failure.
- To outline the current management strategies for bone health in this patient population.
Main Methods:
- Literature review focusing on diagnosis and management of metabolic bone diseases in intestinal failure.
- Synthesis of current evidence regarding etiological factors and therapeutic interventions.
Main Results:
- Identified key etiological factors including inflammatory bowel disease, corticosteroid use, nutrient malabsorption, and parenteral nutrition contaminants.
- Highlighted the impact of reduced enterocyte mass and gut function on bone health.
- Discussed the historical role of aluminum in parenteral nutrition contributing to bone disease.
Conclusions:
- Metabolic bone diseases pose a significant challenge in patients with intestinal failure.
- Comprehensive diagnosis and tailored management are crucial for optimizing bone health.
- Addressing underlying causes, malabsorption, and nutritional support is essential for preventing and treating bone complications.
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