Is Crohn’s Disease Bad for Your Bones?
Having Crohn’s disease puts you at risk for bone loss, but that doesn’t mean osteoporosis and other problems are inevitable. Take action now to protect your bone health.
How can a condition like Crohn’s disease lead to bone loss? Your dietary limitations might mean that you’re eating a poor diet, or you might not be absorbing enough nutrients from the foods that you do eat. This can lead to calcium and vitamin D deficiencies, among other nutritional shortages. Vitamin D deficiency is also a side effect of long-term treatment with steroids for Crohn’s disease.
These deficiencies can, in turn, result in different types of disorders related to bone loss, including osteoporosis, osteopenia, and osteomalacia.
“Osteoporosis is a systemic skeletal disease defined as a loss of bone mass and is associated with the deterioration of bone tissue,” explains Ryan S. Carvalho, MD, an attending physician in the division of gastroenterology and nutrition at Nationwide Children’s Hospital in Columbus, Ohio. “Osteopenia is a condition where bone mineral density is lower than normal. Osteomalacia refers to a softening of your bones, often caused by a vitamin D deficiency; in children, this condition is called rickets.”
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In other words, osteopenia is the thinning of bone mass, which can eventually lead to osteoporosis. Osteomalacia results from a defect in the bone-building process, while osteoporosis develops due to a weakening of previously constructed bone, according to the Mayo Clinic.
Preventing Bone Loss Due to Crohn’s Disease
Though calcium and vitamin D deficiencies and the bone loss that can follow are common side effects of Crohn’s disease, they are not inevitable. Here are steps you can take to protect your body and your bones from these complications:
- Work closely with your doctor. Part of your doctor’s strategy for helping you fight Crohn’s disease should be preventing bone loss. If your doctor doesn’t bring up concerns related to your bones, be sure to ask about it.
- Try bone-boosting strategies. Steps you can take on your own to help preserve bone density include getting regular exercise and eating a diet rich in calcium (think milk and dark green vegetables) and vitamin D (fortified milk and fatty fish). You can also get an adequate dose of vitamin D through a few minutes of sun exposure each day. Finally, avoid smoking and excessive drinking in order to preserve your bone health.
- Consider supplements. In some cases, you may need to take calcium and vitamin D supplements to avoid bone loss. Ask your doctor to help you work out the proper dosage of each supplement.
- Manage steroids. Because steroids can lead to bone loss, changing your Crohn’s disease medication might be a strategy. Discuss possible options with your doctor, including going off steroids entirely, taking medications with a smaller steroid component, or taking drugs that support bone health along with the steroid treatments.
- Get additional screenings. Because of the risks related to bone loss, Dr. Carvalho says it’s reasonable to monitor your bone density more often than suggested in guidelines for the general population. In addition, children with Crohn’s disease should have their growth measured at regular intervals to make sure there aren’t any delays related to bone density problems.
Bone health is yet another aspect of Crohn’s disease that needs to be managed, but all of these steps will benefit your overall health at the same time.