What Is Inflammatory Bowel Disease?

Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that affect nearly one million Americans. Crohn’s disease tends to affect the small intestine, although any part of the digestive tract may be involved. Ulcerative colitis usually causes an inflammation in all or part of the large intestine. People with inflammatory bowel disease (IBD) often have diarrhea, abdominal pain, fever, and weight loss.

The cause(s) of Crohn’s disease and ulcerative colitis are unknown. It is sometimes difficult to distinguish one disease from the other, and there is no cure for either condition. Medications are often prescribed to control the symptoms of IBD and, in some cases, surgical removal of the involved intestine may be necessary.

What Is Osteoporosis?

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in pain and disability. Osteoporosis is a major health threat for an estimated 44 million Americans. While postmenopausal Caucasian women have the highest risk for the disease, men and certain ethnic populations are also at risk.

Risk factors for developing osteoporosis include:

• being thin or having a small frame;
• having a family history of the disease;
• for women, being postmenopausal, having an early menopause, or not having menstrual periods (amenorrhea);
• using certain medications, such as glucocorticoids;
• not getting enough calcium;
• not getting enough physical activity;
• smoking; and,
• drinking too much alcohol.

Osteoporosis is a disease that often can be prevented. However, if undetected, it can progress for many years without symptoms until a fracture occurs.

The Inflammatory Bowel Disease–Osteoporosis Link

The Crohn’s and Colitis Foundation of America reports that 30 to 60 percent of people with IBD may have low bone density, which puts them at significant risk for osteoporosis. People with IBD are often treated with medications known as glucocorticoids (such as prednisone or cortisone) to reduce the inflammation caused by their disease. Over time, these drugs interfere with the development and maintenance of healthy bones. Bone loss increases with the amount and length of glucocorticoid therapy.

In addition, people with severe inflammation of the small bowel and/or those who have parts of the small bowel surgically removed may have difficulty absorbing calcium and vitamin D. This is an additional concern for bone health.

Osteoporosis Management Strategies

To protect and promote bone health, people with IBD should eat a diet rich in calcium and vitamin D and participate in an appropriate exercise program. Not smoking and avoiding excessive use of alcohol are also important. In some cases, medication to prevent further bone loss may be recommended, especially for those on long-term glucocorticoid therapy.

Nutrition: A diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Also, supplements can help ensure that the calcium requirement is met each day. According to the National Academy of Sciences, adults under 50 years of age need 1,000 mg of calcium each day, while those over 50 need 1,200 mg.