Bone health in patients with inflammatory bowel disease

Chedid, 2020Gastroenterological Society of Australia (GESA), 2018

Inflammatory bowel disease is associated with an increased risk of osteopenia and osteoporosis, particularly in patients who have used systemic corticosteroids. Screening, monitoring and prophylaxis for osteopenia and osteoporosis are important.

General measures to prevent osteopenia and osteoporosis include regular weight-bearing exercise, adequate calcium intake (see Calcium and osteoporosis), and stopping smoking and excessive alcohol consumption.

For patients taking frequent courses of systemic corticosteroid therapy, measure bone mineral density every 12 to 24 months for the first few years of therapy. If bone mineral density is stable and acceptable, further bone mineral density measurements can be less frequent. Correct vitamin D deficiency, and give calcium supplementation if intake is inadequate. Also consider bisphosphonate therapy for patients with more severe osteopenia or osteoporosis. For more information on preventing and treating glucocorticoid-induced osteoporosis, see Glucocorticoid-induced osteoporosis.