November 06, 2012
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IBS increased risk for osteoporosis, related fractures

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LAS VEGAS — Patients with IBS are more likely to develop osteoporosis and are at increased risk for osteoporosis-related fractures, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.

The study included 317,857 emergency department visits for patients with secondary IBS diagnoses, collected from the 2008 Nationwide Emergency Department Sample database, and compared them with controls without IBS. The presence of and risk for osteoporosis and related fractures within the IBS cohort was evaluated, along with potential predictive factors. Analysis included pathologic wrist, vertebrae and femur fractures and traumatic wrist, vertebrae and hip fractures.

Within the assessed cohort, 17,752 patients had an osteoporosis diagnosis, with concurrent fracture diagnoses in 2,197 cases. Risk for osteoporosis was elevated among patients with IBS (OR=4.28; 95% CI, 4.21-4.35), as was risk for osteoporotic fracture (OR=2.36; 95% CI, 2.26-2.47) compared with controls.

Osteoporosis risk was higher in the IBS cohort regardless of age or sex, but the increase was less pronounced among older patients. Investigators calculated ORs of 4.86 (3.09-7.65) for males and 4.46 (3.78-5.25) for females aged 0 to 40 years; 4.98 (4.31-5.75) for males and 3.55 (3.43-3.68) for females aged 41 to 65 years, and 3.08 (2.81-3.39) for males and 2.79 (2.73-2.84) for females aged 66 and older (95% CI for all).

Fractures of the vertebrae, hip and wrist were more likely among patients with IBS, with the greatest risk increase for wrist fractures (OR=2.41, 2.10-2.77). Patients with IBS were at greater risk for hip and wrist fractures than patients with either Crohn’s disease (OR=1.47, 1.28-1.69 for hip fractures; OR=1.6, 1.20-2.14 for wrist fractures) or ulcerative colitis (OR=1.55, 1.31-1.83 for hip; OR=0.7, 0.41-1.22 for wrist fractures).

“In gastroenterology, we are cognizant of the fact that some of our patients with chronic GI diseases are at higher risk for osteoporosis,” researcher Eli D. Ehrenpreis, MD, head of the division of gastroenterology at NorthShore University HealthSystem, told Healio.com. “We’ve been very well-educated about that risk in patients with IBD and celiac disease. … Our study identifies IBS as a significant risk factor for osteoporosis and for bone fracture. Those patients should be screened for the development of osteoporosis, and should be advised about their increased risk of osteoporosis and bone fracture.”

For more information:

Stobaugh DJ. P1016: Increased Risk of Osteoporosis-Related Fractures in Patients with Irritable Bowel Syndrome. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.