Vnitr Lek 1998, 44(3):162-165

[Disorders of bone mineralization and their treatment in Crohn's disease].

J Kocián, J Kociánová: I. interní klinika IPVZ-FTN, Praha 4.

Frequent complications of Crohn's disease include disorders of bone mineralization. They are due to a reduced dietary calcium supply in patients with lactose intolerance and a certain degree of malabsorption of calcium as well as vitamin D. The position is made worse by corticoids used in treatment of the basic disease, because they interfere not only with vitamin D conversion into its active (and much more effective) metabolites but also with osteoid formation In the early diagnosis of demineralization a densitometer can be used; markers of bone metabolism are used so far less frequently. As to treatment either blockers of enhanced bone resorption can be used (Ca, vitamin D, bisphosphonates and thyrocalcitonin) or substances stimulating new formation of bone (F, growth factors, in postmenopausal women hormonal substitution treatment) or a combination of preparations from both groups can be used. An irreplaceable part is played also by exercise, depending, of course, on the patient's general condition.