Gastrointestinal Disorders and Bone Health
This article was published by the National Institutes of Health Osteoporosis and Related Bone Diseases~National Resource Center
2 AMS Circle, Bethesda MD 20892-3676
Celiac disease or sprue is an inherited intestinal disorder in which gluten intolerance alters the body's ability to absorb these and other nutrients. Gluten is a protein found in wheat, rye, barley, farina, semolina and bulgar. Individuals with celiac disease often consume adequate amounts of calcium, but it cannot be absorbed. For this reason, low bone density is common in untreated and newly diagnosed cases of celiac disease. When foods containing gluten are eliminated from the diet, normal absorption from the intestines is restored.
In some cases, the diagnosis is missed because the only symptom the person has is occasional diarrhea or failure to gain or maintain body weight. The amount of bone a person loses will depend on the age at diagnosis and the onset of treatment with a gluten-free diet. When celiac disease is diagnosed and treated in childhood, peak bone density often is achieved and maintained. Even untreated adults with celiac disease have experienced improvement in bone density once they are treated with a gluten-free diet.
Diagnosis is usually made with a special antibody blood test or by examining a small piece of intestinal tissue removed in a biopsy.
For more information, contact:
PO Box 105
Hastings-on-Hudson, NY 10706
Celiac Sprue Association
PO Box 31700
Omaha, NE 68131-0700
Inflammatory Bowel Disease
Crohn's disease and ulcerative colitis are inflammatory bowel diseases that affect nearly 2 million Americans. Crohn's disease tends to affect the small intestine, although any part of the digestive tract may be involved, and ulcerative colitis usually causes an inflammation involving all or part of the large intestine. Individuals with inflammatory bowel disease (IBD) often have diarrhea, abdominal pain, fever and weight loss. The cause of these diseases is unknown, it is often difficult to distinguish one disease from the other and there is no cure for either condition. Medications often are prescribed to control the symptoms of IBD, and, in some cases, surgical removal of the involved intestine may be necessary.
The Crohn's and Colitis Foundation of American reports that 30-60 percent of people with IBD may have low bone density, which puts them at significant risk for osteoporosis. People with IBD often are treated with glucocorticoids (prednisone or cortisone) to reduce the inflammation caused by their disease. Over time, these drugs interfere with the bone remodeling process and calcium balance. Bone loss increases with the dose and duration of glucocorticoid therapy.
IBD individuals who have extensive inflammation of the small bowel and/or have parts of the small bowel surgically removed may have difficulty absorbing calcium and vitamin D -- a further concern for bone health.
For more information contact:
Crohn's and Colitis Foundation of America
386 Park Avenue South
New York, NY, 10016-8804
To promote bone health, individuals with celiac disease or IBD should consume a diet rich in calcium and vitamin D and participate in an appropriate exercise program. In some cases, a bone density test and medication to prevent further bone loss may be recommended, especially for those on long term glucocorticoid therapy.
Nutrients from the food we eat, including calcium and vitamin D, are absorbed into the bloodstream through the intestinal tract. However, people with intestinal disorders such as celiac disease, Crohn's disease or ulcerative colitis are unable to absorb many of the nutrients essential for good health, especially bone health.
Revision Date: 12/1998
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