Bone loss in patients with the ileostomy and ileal pouch for inflammatory bowel disease

Abstract

Low bone mineral density (BMD) or low bone mass is common in patients with inflammatory bowel disease (IBD). Studies have shown that low BMD is also common in patients with ulcerative colitis (UC) even after colectomy and ileal pouch–anal anastomosis (IPAA). The reported frequency of osteopenia ranged from 26–55% and that of osteoporosis ranged from 13–32% in patients with IPAA. Increasing age, low body mass index, lack of calcium supplementation and high inflammatory activity with villous atrophy in the ileo-anal pouch are risk factors for low bone mass in pouch patients. Bone loss is also common in patients with IBD and ostomy. Current professional society guidelines do not specifically address the need for surveillance in patients with ileal pouches or ostomy. A growing body of evidence suggests that patients with ileal pouch or ostomy are at an increased risk of bone loss. Pending prospective studies, screening and surveillance using dual energy X-ray absorptiometry (DEXA) along with calcium/vitamin D supplementation may be beneficial in those patients.

High-resolution Quantitative Computed Tomography Demonstrates Structural Defects in Cortical and Trabecular Bone in IBD Patients

“…27 Finally, resection of the terminal ileum in CD or ileoanal pouch in ulcerative colitis [UC] may pose additional risks to bone in IBD patients. 28,29,30,31 Herein, we provide an in-depth analysis of bone structure of patients with CD and UC by using state-of-the-art bone analysis with HR-pQCT analysis. We show a significant deterioration of total, cortical, and trabecular bone micro-architecture in IBD patients.…”

Nutritional Issues Faced by Patients with Intestinal Stoma: A Narrative Review

“…The scientific literature reports an increased risk of osteomalacia and osteoporosis, combined with a calcium deficiency in people who have an intestinal stoma created as a result of inflammatory bowel disease. There is a need for further research and guidelines from scientific societies in this regard because preventive measures can bring many benefits to the examined [ 34 , 35 ].…”

Επιδημιολογικά Χαρακτηριστικά, Παράγοντες Κινδύνου Και Παθογενετικοί Μηχανισμοί Ανάπτυξης Οστεοπόρωσης Και Καταγμάτων Σε Κρητικούς Ασθενείς Με Ιδιοπαθείς Φλεγμονώδεις Εντερικές Νόσους

“…Πρωκτοκολεκτοµή µε ειλεο-ορθική αναστόµωση (IPAA) είναι η επέµβαση εκλογής για την θεραπεία των περισσότερων ασθενών µε ανθεκτική ελκώδη κολίτιδα, ελκώδη κολίτιδα µε δυσπλασία και οικογενής αδενωµατώδη πολυποδίαση (168,169). Μερικές µελέτες έδειξαν µια αύξηση στην οστική πυκνότητα µετά από ολική κολεκτοµή µε ΙPAA (165).…”