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Bone Health in Pediatric Inflammatory Bowel Disease

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Pediatric Inflammatory Bowel Disease

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Abstract

Children with inflammatory bowel disease (IBD) are at risk for impaired bone mineral accrual. Multiple risk factors for impaired bone development have been recognized; including poor growth, delayed maturation, malnutrition, decreased weight-bearing activity, chronic inflammation, genetic susceptibility, and immunosuppressive therapies, such as glucocorticoids. The impact of these threats may be immediate, resulting in fractures during childhood and adolescence or delayed, due to suboptimal peak bone mass accrual. This chapter summarizes the normal changes in bone density and structure during growth, as well as the risk factors for poor bone accrual in childhood IBD. The classification of bone health in children and adolescents is discussed, as are the advantages and disadvantages of available technologies for the assessment of bone in children and adolescents. The difficulties in assessing and interpreting bone measures in pediatric IBD are underscored, as is the process of identifying discrete determinants of bone deficits in pediatric IBD. Currently, the prevention of bone disease is best accomplished by controlling inflammation, providing adequate calcium and vitamin D supplementation, and encouraging physical activity. However, additional studies are needed to fully appreciate the magnitude of bone disease in pediatric IBD, as well as the implications for lifetime fracture risk and targeted therapies.

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Authors and Affiliations

  1. Department of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Meena Thayu MD, MSCE

  2. Division of Gastroenterology, Hepatology, and Nutrition, University of Pennsylvania School of Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, 19104-4399, USA

    Edisio Semeao MD

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  1. Meena Thayu MD, MSCE
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  2. Edisio Semeao MD
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Correspondence to Meena Thayu MD, MSCE .

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Editors and Affiliations

  1. Perelman School of Medicine, The Children’s Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Petar Mamula

  2. School of Medicine--Greenville, Pediatric Gastroenterology & Nutrition, University of South Carolina, 200 Patewood Drive, Suite A-140, Greenville, 29615, South Carolina, USA

    Jonathan E. Markowitz

  3. Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Robert N. Baldassano

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Thayu, M., Semeao, E. (2013). Bone Health in Pediatric Inflammatory Bowel Disease. In: Mamula, P., Markowitz, J., Baldassano, R. (eds) Pediatric Inflammatory Bowel Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5061-0_23

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