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WGO practice guideline: Osteoporosis and gastrointestinal diseases

Document presentation of content: Epidemiology, osteoporosis in GI/Liver associated conditions, etiology, diagnosis, management of osteoporosis, literature references, links to useful websites and consensus statements, queries and feedback. | WGO Practice Guideline Osteoporosis and gastrointestinal diseases 7 October 2003 revised June 2004 Review Team Professor Alan B.R. Thomson University of Alberta Canada Dr. K. Siminoski University of Alberta Canada Professor Michael Fried University Hospital Zurich Switzerland Dr Roques Saenz University del Desarrollo Chile Professor Henry Cohen Clinica de Endoscopia y Gastroenterologia Uruguay Professor A. Elewaut Gent University Hospital Belgium Professor Ole Thomsen University of Copenhagen Denmark Drs. Justus Krabshuis Highland Data France Sections 1. Definition 2. Epidemiology 3. Osteoporosis in GI Liver associated conditions 4. Etiology 5. Diagnosis 6. Management of Osteoporosis 7. Literature References 8. Links to useful websites and consensus statements 9. Queries and feedback 1. Definition Osteoporosis is a systemic disease characterized by low bone mass osteopenia and micro-architectural deterioration resulting in an increased risk of fracture. 1 2 . Gastroenterologists will encounter patients in their practices with osteoporosis osteopenia and practice guidelines about diagnosis presentation and treatment would be useful. Abbreviations BMD Bone mineral density CD Crohn s disease DXA Dual-energy x-ray absorptiometry FIT Fracture intervention trial FSH Follicle stimulating hormone GCS Glucocorticosteroids GGT Gamma glutamyl transferase GI Gastrointestinal HRT Hormone replacement therapy IBD Inflammatory bowel disease LH luteinizing hormone NSAID Non-Steroidal Anti-Inflammatory Drugs PBC Primary biliary cirrhosis PSC Primary sclerosing cholangitis PTH Parathyroid hormone SERMs Selective estrogen receptor modulators SD Standard deviation UC Ulcerative colitis 2. Epidemiology Some simple facts Peak bone mass is achieved by 30 years After skeletal maturity bone is lost at a rate of 0.5 - 1.0 per year Women experience a phase of accelerated bone loss for 3-5 years after menopause When bone density falls with age fracture risk increases The incidence of .