J Bone Metab.  2018 Nov;25(4):213-217. 10.11005/jbm.2018.25.4.213.

Osteoporosis and Osteoporotic Fractures in Gastrointestinal Disease

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.
  • 2Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. cragy0215@naver.com

Abstract

Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the post-gastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.

Keyword

Celiac disease; Gastrectomy; Inflammatory bowel diseases; Osteoporosis; Osteoporotic fractures

MeSH Terms

Bone Diseases
Bone Diseases, Metabolic
Celiac Disease
Female
Gastrectomy
Gastrointestinal Diseases*
Humans
Inflammatory Bowel Diseases
Osteoporosis*
Osteoporotic Fractures*
Prevalence
Stomach Neoplasms
Survivors

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Reference

1. Zittel TT, Zeeb B, Maier GW, et al. High prevalence of bone disorders after gastrectomy. Am J Surg. 1997; 174:431–438.
Article
2. Seo GH, Kang HY, Choe EK. Osteoporosis and fracture after gastrectomy for stomach cancer: a nationwide claims study. Medicine (Baltimore). 2018; 97:e0532.
3. Yoo SH, Lee JA, Kang SY, et al. Risk of osteoporosis after gastrectomy in long-term gastric cancer survivors. Gastric Cancer. 2018; 21:720–727.
Article
4. Melton LJ 3rd, Crowson CS, Khosla S, et al. Fracture risk after surgery for peptic ulcer disease: a population-based cohort study. Bone. 1999; 25:61–67.
Article
5. Nilsson BE, Westlin NE. The fracture incidence after gastrectomy. Acta Chir Scand. 1971; 137:533–534.
6. Oh HJ, Lim CH, Yoon BH, et al. Fracture after gastrectomy for gastric cancer: a long-term follow-up observational study. Eur J Cancer. 2017; 72:28–36.
Article
7. Kwon SJ, Hahm JS, Cho YJ, et al. The influence of gastrectomy on the change of bone metabolism and bone density. Korean J Intern Med. 2000; 15:25–31.
Article
8. Liedman B, Bosaeus I, Mellström D, et al. Osteoporosis after total gastrectomy. Results of a prospective, clinical study. Scand J Gastroenterol. 1997; 32:1090–1095.
Article
9. Nilas L, Christiansen C. Influence of PTH and 1,25(OH)2D on calcium homeostasis and bone mineral content after gastric surgery. Calcif Tissue Int. 1985; 37:461–466.
Article
10. Baek KH, Jeon HM, Lee SS, et al. Short-term changes in bone and mineral metabolism following gastrectomy in gastric cancer patients. Bone. 2008; 42:61–67.
Article
11. Maier GW, Kreis ME, Zittel TT, et al. Calcium regulation and bone mass loss after total gastrectomy in pigs. Ann Surg. 1997; 225:181–192.
Article
12. Tovey FI, Hall ML, Ell PJ, et al. A review of postgastrectomy bone disease. J Gastroenterol Hepatol. 1992; 7:639–645.
Article
13. Stenström M, Olander B, Lehto-Axtelius D, et al. Bone mineral density and bone structure parameters as predictors of bone strength: an analysis using computerized microtomography and gastrectomy-induced osteopenia in the rat. J Biomech. 2000; 33:289–297.
Article
14. Bernstein CN, Leslie WD, Leboff MS. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology. 2003; 124:795–841.
Article
15. Bernstein CN, Seeger LL, Sayre JW, et al. Decreased bone density in inflammatory bowel disease is related to corticosteroid use and not disease diagnosis. J Bone Miner Res. 1995; 10:250–256.
Article
16. Bjarnason I, Macpherson A, Mackintosh C, et al. Reduced bone density in patients with inflammatory bowel disease. Gut. 1997; 40:228–233.
Article
17. Pollak RD, Karmeli F, Eliakim R, et al. Femoral neck osteopenia in patients with inflammatory bowel disease. Am J Gastroenterol. 1998; 93:1483–1490.
Article
18. Roux C, Abitbol V, Chaussade S, et al. Bone loss in patients with inflammatory bowel disease: a prospective study. Osteoporos Int. 1995; 5:156–160.
Article
19. Bernstein CN, Blanchard JF, Leslie W, et al. The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Ann Intern Med. 2000; 133:795–799.
Article
20. Vestergaard P, Krogh K, Rejnmark L, et al. Fracture risk is increased in Crohn's disease, but not in ulcerative colitis. Gut. 2000; 46:176–181.
Article
21. Vestergaard P, Mosekilde L. Fracture risk in patients with celiac Disease, Crohn's disease, and ulcerative colitis: a nationwide follow-up study of 16,416 patients in Denmark. Am J Epidemiol. 2002; 156:1–10.
Article
22. Loftus EV Jr, Crowson CS, Sandborn WJ, et al. Long-term fracture risk in patients with Crohn's disease: a population-based study in Olmsted County, Minnesota. Gastroenterology. 2002; 123:468–475.
Article
23. Tilg H, Moschen AR, Kaser A, et al. Gut, inflammation and osteoporosis: basic and clinical concepts. Gut. 2008; 57:684–694.
Article
24. Valdimarsson T, Löfman O, Toss G, et al. Reversal of osteopenia with diet in adult coeliac disease. Gut. 1996; 38:322–327.
Article
25. Meyer D, Stavropolous S, Diamond B, et al. Osteoporosis in a North American adult population with celiac disease. Am J Gastroenterol. 2001; 96:112–119.
Article
26. Fickling WE, McFarlane XA, Bhalla AK, et al. The clinical impact of metabolic bone disease in coeliac disease. Postgrad Med J. 2001; 77:33–36.
Article
27. Walters JR, Banks LM, Butcher GP, et al. Detection of low bone mineral density by dual energy x ray absorptiometry in unsuspected suboptimally treated coeliac disease. Gut. 1995; 37:220–224.
Article
28. Jafri MR, Nordstrom CW, Murray JA, et al. Long-term fracture risk in patients with celiac disease: a population-based study in Olmsted County, Minnesota. Dig Dis Sci. 2008; 53:964–971.
Article
29. Ludvigsson JF, Michaelsson K, Ekbom A, et al. Coeliac disease and the risk of fractures - a general population-based cohort study. Aliment Pharmacol Ther. 2007; 25:273–285.
Article
30. García-Manzanares A, Tenias JM, Lucendo AJ. Bone mineral density directly correlates with duodenal Marsh stage in newly diagnosed adult celiac patients. Scand J Gastroenterol. 2012; 47:927–936.
Article
31. Ludvigsson JF, Bai JC, Biagi F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014; 63:1210–1228.
Article
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