Link Between Osteoporosis and Coeliac Disease

The coeliac disease is an auto-immune disease that is defined by the sensitivity of the wall of the small intestine to gluten that causes failures with poor digestion.¹ Due to coeliac disease in patients, their bones become fragile and porous which attributes to a lack of calcium in the body. This is known as osteoporosis. This is a common problem for women in the postmenopausal state. The fracture in the bones happens to the people due to this problem after fifty years of age. Majorly the fractures take place in spine, forearm, and hip. According to the reports, the estimated total annual cost of osteoporotic fracture patients is £ 742 million. These costs are likely to increase as the population ages.

Patients with osteoporosis have produced highly varying risk estimates for the prevalence of coeliac disease. Various test and studies have been done to check the presence of coeliac disease in the patients with osteoporosis; some of these methods include fixed-effects inverse variance-weighted models, and testing heterogeneity through subgroup analysis as well as through meta-regression. Coeliac disease is a common digestive condition where the small intestine(bowel) becomes inflamed and unable to absorb nutrients, this disease is found to cause by an adverse reaction to gluten, a dietary protein found in three types of cereals namely wheat, barley, rye. Osteoporosis is basically a complication that occurs due to untreated coeliac disease in one’s body.

Children and adults with untreated coeliac disease may become malnourished which results in weight loss and delayed growth in children. This results in the loss of bones in adults which increase the risk of osteoporosis. Coeliac disease is treated by following a gluten-free diet.²

Osteoporosis is a silent disease and if undetected then it progresses for many years without symptoms until a fracture occurs. It can be prevented by building healthy bones in youth that prevents fractures later in life.

Osteoporosis is a condition Where in the bone tends to lose its density and lead to fractures.³ This can lead to pain or disabilities. Although this osteoporosis is prevalent among postmenopausal women, men and the certain ethnic population is also at risk.

Factors or Signs for Developing Osteoporosis:

• Genes or Family History
• Low calcium intake
• Smoking
• Being postmenopausal and having early menopause. (only applicable to women)
• Abnormal absences of menstrual periods. (only applicable to women)

Coeliac disease is an autoimmune condition, in this condition, the immune system (body’s defense against infection) of body mistakenly attacks the healthy tissue. In this disease, the immune system mistakes the substance found inside gluten as a threat to the body and attacks them. This damages the surface of the intestine, disrupting the body’s ability to absorb nutrients.

The small intestine must observe the relevant nutrients to feed the body With energy. Calcium can be considered as an essential thing that build and maintains healthy bones. People who suffer from coeliac disease make consume relevant calcium which is usually deficient here. Due to the fact that the calcium is required for the body and wants to be healthy, the low bone density we can become common and lead to coeliac disease.

Symptoms of Coeliac Disease

• Diarrhea
• Abdominal pain
• Indigestion
• Constipation
• Bloating
• Flatulence
• Fatigue as a result of malnutrition
• Unexpected weight loss

The people with coeliac disease and having osteoporosis should take the diet having calcium and vitamin D, performing weight-bearing exercise, must avoid smoking and alcohol. Medicines also required treating osteoporosis.

• Nutrition- The well-balanced diet rich in calcium and vitamin D is taken to make the bones strong and healthy. Calcium can be obtained from low-fat dairy products, green vegetables, calcium-fortified foods, and beverages. Medicines are taken to increase the daily calcium intake as per requirement as age increases. Vitamin D can be obtained from egg yolks, saltwater fish and liver. As per the weather in different locations, the intake of vitamin D varies each day.
• Regular exercise- Weight-bearing exercise is the best kind of activities that force the individual to work against gravity.
• Healthy lifestyle- Smoking is not healthy for bones as well as heart and lungs. Females who smoke tend towards menopause stage so earlier and results in reducing the level of a bone-preserving hormone that is estrogen and there will be an early loss of bone. The people who smoke also absorb less calcium from their diets. Consumption of alcohol is reduced as it also has a negative effect on bone health.
• Bone density test- This bone mineral density test covers bone density in various sites of the body. This test usually detects osteoporosis before the fracture of the bone occurs. This test helps the individual whether one should take medicines or not.
• Medication- Several medicines are available to prevent and treat osteoporosis of coeliac disease patients and should be taken on time as prescribe by the doctor.

A study shows that around 47% of women and 50% of men have this problem of osteoporosis who are suffering from coeliac disease. So, from this we conclude that this is a common problem of coeliac disease patients suffering from osteoporosis. One should follow the strict diet, do regular exercise, take medicines and visit the doctor regularly to live a healthy life free from coeliac disease. All the essential vitamins and calcium-containing food should be taken to stay fit and healthy.

It is found that about 1 in 62 individuals with osteoporosis, or 1.6%, have biopsy-verified coeliac disease. This prevalence is comparable to that in the general population. There is no permanent treatment for coeliac disease but one can follow a strict, lifelong gluten-free diet, it is the only way to manage the coeliac disease. Healthy lifestyle and exercising daily would help to manage both osteoporosis and coeliac disease.

References: