Vertebral fractures in Crohn's disease.





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Crohn's disease is serious chronic illness that inflicts severe damage to the intestinal tract, causing diarrhea and abdominal pain. Though it can strike anywhere along the GI tract from the mouth to the anus, Crohn's disease usually affects the endmost portion of the small intestine, called the "ileum."

Crohn's disease is an inflammatory condition; the delicate mucous membrane lining the intestinal wall becomes inflamed and ulcerated in spots called "skip lesions." The intestinal lining looks somewhat like an old cobblestone street, with lesions spaced between normal tissue. The inflammation can penetrate the bowel wall, leading to the development of abscesses and deep cracks. Even worse, these cracks may lengthen, forming complete openings from the inside of the intestine to the outside called "fistulas." The intestinal wall eventually becomes hardened and inflexible. In later stages of the disease, the intestine may become obstructed.

Many health problems can result from Crohn's disease. One of these problems can be osteoporosis or osteopenia. A recent study investigated the prevalence of vertebral fractures in those suffering from Crohn's disease. Researchers recruited 293 patients with Crohn's disease and examined the spine using X rays. Out of the 293 patients, 156 had osteopenia or osteoporosis and were required to go through further X rays. The results showed that out of the 156 individuals, 63 had visible fracture lines and 13 had evidence of fractures. In addition, one-third of those with fractures were under the age of 30 years. The authors concluded that, "in patients with Crohn’s disease and reduced bone mineral density, the prevalence of vertebral fractures—that is, manifest osteoporosis—was strikingly high at 22%, even in those aged less than 30 years, a problem deserving further clinical attention."1


1. Klaus J, et al. High prevalence of osteoporotic vertebral fractures in patients with Crohn’s disease. Gut. Nov 2002;51:654-8.