Bone Abstracts

The term ‘inflammatory bowel disease’ (IBD) describes a chronic and relapsing inflammation. Up to 25% of all patients with IBD develop the disease during childhood and adolescence. IBD is considered one of the most common chronic childhood diseases in the Western world. Besides epidemiologic data, a short overview about disease presentation, diagnostic criteria and current treatment strategies will be given.

The etiology of IBD is still unknown but it is considered to be multifactorial. It has been hypothesized that a yet unidentified trigger may, in a genetically susceptible individual with an altered intestinal microbial flora and in association with particular environmental factors, activate an aberrant immune response, which results in a chronic intestinal inflammation. Key players in the inflammatory process are cytokines such as tumor necrosis factor-α (TNF-α) and interleukin6 (IL6) that are released from the inflamed mucosa. Possible links between autoimmune disease and bone metabolism will be highlighted.

The association between IBD and bone mineral density (BMD) was first described in the 1960s. Since the introduction of new methods of BMD measurement in the early 1990s, several studies have concluded that low BMD is common in both adults and children who suffer from IBD. However, only few studies have investigated the clinical relevance of low BMD, the occurrence of fractures, in IBD patients. An overview over studies that are available to date will be given. In addition, current guidelines and recommendations regarding evaluation, treatment and follow-up of low BMD in IBD patients will be reviewed.