Newsletters

Fall 2005

Trick or Treat: Your Tummy or Your Bones?

Here is a skeletal health question: What do your intestines have to do with your bones? The answer is: Lots. In order to have strong bones, you need to provide them with essential nutrients, such as calcium and vitamin D. If you are taking a prescription medicine for osteoporosis, it must reach your bones to be effective.

Food, vitamins, supplements, and medications taken by mouth must be absorbed by the intestinal tract before they have an opportunity to reach the “target” organ– in this case, the skeleton. Even if you do everything your doctor advises, it is possible that an uncooperative intestinal tract may prevent you from benefiting. How often does this happen? More than you think.

Recently, researchers have taken a close look at a disease formerly thought to be very rare– celiac disease, also called celiac sprue or non-tropical sprue. In evaluating patients with a diagnosis of osteoporosis, it was found that 3.4% had celiac disease. This was 17 times the chance of finding celiac disease in patients without osteoporosis.
In another study, looking at celiac disease patients only, osteoporosis was very common. Celiac disease may cause no symptoms, yet reduce the absorption of calcium and vitamin D enough to result in osteoporosis.It can be diagnosed with some simple tests and treated with changes in the diet.

Other intestinal problems can cause bone disease. Inflammatory bowel disease, such as Crohn’s disease, may cause malabsorption of many important nutrients. Surgical removal of all or part of the stomach can result in osteoporosis. Patients with gastric bypass surgery for obesity are at high risk for osteoporosis.Chronic diarrhea for any reason may be bad for bones. Chronic liver disease or removal of part of the small intestine is a risk factor for osteoporosis.

Anyone with osteoporosis, especially when not responding to treatment as expected, should be considered for evaluation for intestinal problems.