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Osteomalacia after small-intestinal resection

J E Compston, A B Ayers, L W Horton

    Lancet (London, England)
    |January 7, 1978
    PubMed
    Summary
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    Osteomalacia is common after small-intestinal resection, often missed by standard tests. Bone biopsy is crucial for diagnosis, and oral vitamin D treatments show promise for managing this condition.

    Area of Science:

    • Gastroenterology
    • Endocrinology
    • Orthopedics

    Background:

    • Small-intestinal resection can lead to malabsorption and bone disease.
    • Osteomalacia is a recognized complication, but its prevalence may be underestimated.

    Purpose of the Study:

    • To determine the prevalence of osteomalacia in patients with small-intestinal resection.
    • To evaluate diagnostic methods and treatment options for post-resection osteomalacia.

    Main Methods:

    • Histological examination of bone biopsies from 25 patients post-small-intestinal resection.
    • Analysis of serum calcium, phosphate, and alkaline phosphatase levels.
    • Radiological assessment for osteomalacia.

    Main Results:

    Related Experiment Videos

  • 36% of patients (9/25) had osteomalacia, severe in 5 and mild in 4.
  • Elevated alkaline phosphatase was seen in severe cases; mild cases had normal biochemical markers.
  • Radiology detected osteomalacia in only 3 patients, highlighting diagnostic limitations.

    • Conclusions:

    • Osteomalacia is more common after small-intestinal resection than previously thought.
    • Bone biopsy is essential for accurate diagnosis of osteomalacia in this patient group.
    • Oral vitamin D metabolites offer a practical and effective treatment alternative to parenteral therapy.