CROHN'S DISEASE AND OSTEOPOROSIS: RISK FACTORS, DIAGNOSIS AND CLINICAL TREATMENT

Crohn's disease (CD) is a chronic inflammatory bowel disease that affects any part of the gastrointestinal tract. Osteoporosis, in turn, is a skeletal disease characterized by decreased bone mass and deterioration of bone microarchitecture, increasing the risk of fractures. The association between these two diseases has been increasingly investigated, with evidence suggesting that patients with CD are at increased risk of developing osteoporosis. This comorbidity can be attributed to several factors, including corticosteroid use, nutrient malabsorption, chronic inflammation, and hormonal dysfunction. Objective: The objective of this systematic review was to identify and synthesize the available scientific evidence on the relationship between Crohn's disease and osteoporosis, focusing on risk factors, diagnosis, and clinical treatment. Methodology: A systematic review of the literature was performed, following the recommendations of the PRISMA statement. The PubMed, Scielo and Web of Science databases were searched using the following descriptors: “Crohn’s disease”, “Osteoporosis”, “Risk factors”, “Diagnosis” and “Treatment”. Original articles published in the last 10 years, in Portuguese or English, that investigated the association between CD and osteoporosis in adults were included. Case studies, narrative reviews and articles that did not address the relationship between the two diseases were excluded. Results: The results of the review demonstrated that osteoporosis is a frequent complication in patients with CD. Several risk factors were identified, including the use of corticosteroids, malabsorption of calcium and vitamin D, chronic inflammation and hormonal dysfunction. The diagnosis of osteoporosis in patients with CD can be challenging due to the presence of other factors that can affect bone mineral density, such as malnutrition and immobilization. Treatment of osteoporosis in patients with CD should be individualized and may include pharmacological and non-pharmacological measures, such as calcium and vitamin D supplementation, regular physical activity, and reduced tobacco and alcohol consumption. Conclusion: Crohn's disease represents a significant risk factor for the development of osteoporosis. The association between these two diseases is complex and multifactorial, involving several pathogenic mechanisms. Early diagnosis and appropriate treatment of osteoporosis in patients with CD are essential to prevent fractures and improve the quality of life of these patients. It is essential that health professionals are aware of this comorbidity and offer integrated clinical management for these patients.