Inflammatory bowel disease occurs in several forms. Because most cases go undiagnosed, past research has been inconsistent when trying to explain whether there is a link between this disease and osteoporosis.
The World Journal of Gastroenterology has now published a study in which researchers try to answer this question by splitting inflammatory bowel disease into its different types.
Inflammatory bowel disease (IBD) is a group of disorders that cause long-term inflammation in the digestive tract. The two main types are ulcerative colitis and Crohn’s disease.
Ulcerative colitis causes inflammation in the large intestine and rectum, while Crohn’s disease can cause inflammation absolutely anywhere from the mouth to the rectum, with the most common area of infection being the small and large intestines.
For some basic anatomy, let’s remind you that your digestive tract runs from top to bottom from your mouth to your esophagus, stomach, small intestine, large intestine, and rectum.
This means that ulcerative colitis usually inflames an area lower in your digestive tract than Crohn’s disease does.
Because previous research on the relationship between IBD and osteoporosis has been inconsistent, the authors of this study reviewed all of the available literature, with an emphasis on studies that separated ulcerative colitis from Crohn’s disease in their analyses.
They searched medical databases for relevant studies and also examined studies presented at United European Gastroenterology Week, the European Crohn’s and Colitis Organization Congress, and Digestive Disease Week between 2014 and 2018.
They found 12 studies with 3,661 participants with IBD and 12,789 healthy controls for comparison.
In the healthy controls, the prevalence of osteoporosis and osteopenia was 3–10%. In people with ulcerative colitis, it was 2–9%. In people with Crohn’s disease, it was 7–15%. In people with both conditions, the prevalence of these diseases was 4–9%.
Therefore, osteoporosis and osteopenia are most common in people with Crohn’s disease alone, who have higher disease prevalence rates than the healthy population.
It is not known why Crohn’s disease seems to put us at risk of osteoporosis.
Your digestive tract is supposed to break down food and extract nutrients from it. Since Crohn’s disease tends to destroy the cells that are meant to carry out these functions over a larger part of your digestive tract that ulcerative colitis does, it makes sense that people with Crohn’s disease absorb even fewer nutrients than those with ulcerative colitis do.
This can pose an osteoporosis risk by depriving patients of the calcium, magnesium, potassium, and other minerals and vitamins necessary for bone health.
But this does not explain why people with both conditions have a lower rate of osteoporosis than people with only Crohn’s disease.
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