GASTROENTEROLOGY ARTICLE OF THE WEEK
April 20, 2006
Bernstein CN. Osteoporosis in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2006;4:152-156.
1. Patients at risk for osteoporosis include
a. Active IBD with only prior short-term steroid use
b. Low testosterone levels in males
c. Ileo-colic location of Crohns
d. Past history of low-impact fracture
e. Age
2. Biphosphonate should be strongly considered in:
a. all patients with Crohn’s disease involving the ileum
b. patients with T score <-2.5, or a history of low-impact fractures
c. patients on chronic corticosteroids and T score < -1
d. 5 years after diagnosis of IBD regardless of DEXA score
True or False
3. Young patients with IBD have a marked increased risk of fractures compared to age-matched controls
4. Patients with IBD who have not been treated with steroids usually have a normal DEXA scan
5. DEXA results if by far the most important factor to consider in evaluating IBD patients for osteopenia/osteoporosis
6. Biphosphonates have been shown to be more beneficial for protection of bone mass than calcium and vitamin D in IBD patients
7. Biphosphonates should be continued until T-score is > than -1.
8. Patients presenting with the initial flare of IBD should undergo baseline DEXA scan
9. Recommended doses of calcium and vitamin D are 1,000-1,200 mg daily and 800IU respectively