Title: Osteopenia and bone health in patients with intestinal failure Author
|Abrams, Steven -|
Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: June 1, 2011
Publication Date: January 5, 2012
Citation: Abrams, S.A. 2012. Osteopenia and bone health in patients with intestinal failure. In: Duggan, C.P., Gura, K.M., Jaksic, T., editors. Clinical Management of Intestinal Failure. Boca Raton, FL:CRC Press. p. 271-281. Technical Abstract: This chapter discusses potential etiologies and approaches to the diagnosis and management of bone mineral deficiency in patients with intestinal failure (IF). Unfortunately, data, either from controlled trials or metabolic studies, are extremely limited related to this condition. The focus of this discussion will be on infants and small children, and in particular those who do not have other major comorbidities (e.g., renal failure). Few data have assessed bone outcomes in this group of patients [1,2]. To evaluate bone outcomes it is helpful to consider the components of the diet and environment that lead to bone mineralization and how they may be affected by IF. These include deficiency of dietary or absorbed vitamin D, calcium (Ca), phosphorus (P), and other bone mineral components, as well as the possibility of less sunshine exposure and physical activity. Of these, it is likely that, especially in children, vitamin D deficiency and low amounts of retained Ca and P are the primary factors involved in causing low bone mineralization.