Bone Mineral Density and IBD
Attention to bone health is important in IBD. Patients with IBD are at risk for osteopenia and osteoporosis (weakening of bones secondary to diminished bone mineral density). Possible causes of osteopenia/osteoporosis in IBD are medications (steroids, cyclosporine, methotrexate) and decreased levels of calcium and vitamin D. Other risk factors for diminished bone mineral density include female gender, Caucasian race, older age, low body mass, and cigarette smoking.
To assess the health of your bones, your doctor may order a bone density scan (DEXA). This is simply an x-ray test that measures bone density in the spine and hip; by comparing to standards for healthy individuals, one's risk of osteoporosis can be determined.
If your doctor indicates you are at risk for osteoporosis, calcium and vitamin D supplementation is essential. The recommended daily intake of calcium is 1200 to 1500mg. Because calcium absorption is related to vitamin D levels, patients are advised to take 400 to 800 IU (international units) daily. Calcium is best absorbed when taken after a meal. For patients with clinically significant osteoporosis, bone building medications may be prescribed in addition to calcium and vitamin D supplements. Additional factors that can improve bone health include limiting or eliminating steroids, participating in regular exercise, smoking cessation, and avoiding excessive alcohol intake.