Inflammatory bowel diseases affect small intestine (Crohn’s disease) and large intestines (ulcerative colitis). These diseases make it difficult to digest food and can result in diarrhea and pain as well as limiting nutrient intake. They also make it much more likely that a patient will develop osteoporosis in the long run.
There are two ways inflammatory bowel disease (IBD) and osteoporosis intersect. The reduced ability to absorb nutrients can contribute to the risk of bone health. The short-term importance of calcium and vitamin D in the diet may be overestimated by the public, but long-term deficiencies of these nutrients can contribute to osteoporosis risk. IBD patients sometimes avoid dairy products, and even if they do consume the right foods, the intestines may not function sufficiently to bring enough nutrients into the bloodstream. IBD patients are often advised to take supplements of calcium and vitamin D.
The other risk for IBD patients is secondary osteoporosis caused by medicines used to treat the IBD. Doctors often give these patients glucocorticoids (prednisone or cortisone) and these are known to increase the risk of bone loss.
Lactose intolerance is very common in the population. Those afflicted lack lactase, the digestive enzyme that breaks down the sugar lactose. Milk contains lactose and this condition means after people eat or drink dairy products they develop stomach cramps and diarrhea. Whether they are aware they have the condition or not, people with lactose intolerance generally avoid milk-based products, having learned they do better without them. Because dairy products are a major source of calcium in the common Western diet, these people often have long-term deficiencies in calcium intake. There are other sources of dietary calcium, of course, so lactose intolerance does not mean someone will necessarily fail to get enough calcium, but it is a possibility. There are also concerns that many people without true lactose intolerance fail to maintain an adequate diet and predispose themselves to bone diseases.
Epidemiologists have looked at whether those with lactose intolerance have higher rates of osteoporosis. The results have been mixed. Indeed, this lack of a clear connection was one of the clues that dietary calcium is not as important to osteoporosis risk as once thought.
Celiac disease is a digestive disorder in which the body cannot properly break down gluten in the intestines. Gluten is a proteín found in many grains. Subsequent inflammation of the digestive system prevents adequate absorption of nutrients. Sometimes celiac disease flares up with more symptoms than at other times. There is no treatment other than eliminating gluten from the diet, and this can be difficult. Celiac patients often adopt diets far outside the mainstream in an attempt to control their symptoms.
Calcium malabsorption is a problem in celiac diseases, as is poor absorption of other nutrients. Calcium-containing foods are not necessarily a problem, but the poor functioning of the digestive system caused by the gluten makes malnutrition in general a risk. This is compounded by the fact that Celiac people often go decades before realizing they have the disease. It is only in recent years that awareness of the disease has become widespread.
Scientists have taken an interest in how the nature of the gut microbiome affects bone health.
