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IBD and skeletal health: Children are not small adults!


  • Francisco A Sylvester MD

    Corresponding author
    1. University of Connecticut School of Medicine Connecticut Children's Medical Center
    • Maryland Associate Professor of Pediatrics Division of Digestive Diseases & Nutrition Connecticut Children's Medical Center 282 Washington Street Hartford, Connecticut 06106
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Patients with inflammatory bowel disease often have decreased bone mass, and fragility fractures can occur. Multiple disease- and treatment related factors, including malnutrition, inflammation, malabsorption, decreased weight-bearing physical activity, and corticosteroids negatively influence bone metabolic activity. Because low-impact fracture is the pathologic expression of critically reduced bone mass and bone quality, knowing the relative risk of fractures in patients with IBD is of great interest. The absolute risk for incident fractures in these patients is still being debated. Clinical and laboratory research is clarifying mechanisms by which IBD can affect the function of osteoblasts and osteoclasts. In this concise review, we aim to provide an update on this topic, with focus on how pediatric IBD affects bone health.