Maintain Strong Bones when You Have Crohn's Disease

If you suffer from Crohn’s disease, dealing with the discomfort and symptoms probably feels like enough to worry about. However, it’s also important that you work on keeping your bones strong, as Crohn’s can increase your risk for osteoporosis and bone fractures. Strengthen your bones with Crohn’s disease by working with the appropriate medical professionals, getting enough calcium and vitamin D, and cultivating habits that increase bone strength.

Steps

Getting Medical Treatment

1. Take a calcium supplement. Because your intestine doesn’t absorb nutrients the way it should, you might not get all the calcium you need from your food. If you have low calcium, talk to your doctor about whether you should take a calcium supplement. Calcium promotes strong bones and is important for keeping your bones healthy.
   • The average recommended daily dose is 1,000 milligrams (mg) for adults up to age 50, and 1,200mg for adults age 51 and over. Because people with Crohn’s may not absorb nutrients well, ask your doctor what is an appropriate dose for you to take.
2. Add a vitamin D supplement. Your body needs vitamin D to promote bone growth and so that your body can absorb calcium. If you’re too low in vitamin D, you may need to take a supplement. Ask your doctor if this is appropriate for you.
3. Take prescription medications to prevent osteoporosis. Not everyone with Crohn’s needs to take medicine to prevent weak bones – you may be able to manage the risk with diet and supplements. However, you may qualify for medical therapy if a bone density scan shows your bones are dangerously weak. Ask your doctor about options. They will discuss with you the best possible therapy and weigh the risks and benefits. Some medications that treat osteoporosis include:
   • Bisphosphonates
   • Estrogen
   • Selective estrogen receptor modulators (SERMs)
   • Denosumab
   • Calcitonin
   • Teriparatide

Trying Lifestyle Remedies

1. Quit smoking now. Smoking contributes to your risk for osteoporosis, and can worsen Crohn’s flare-ups. Quit smoking to help improve your symptoms and maintain stronger bones. If you need help quitting, ask your doctor. They may be able to assist you with medications, patches, or gum.
2. Do strength-training and weight-bearing exercises. These exercises help to build stronger bones by increasing bone density. Use free weights, resistance bands, or your body weight to strengthen your major muscle groups. Walk, use the elliptical machine, garden, do Do a Low-Impact Cardio Workout, and climb stairs. How often and how much you should workout depends on your health.
   • Talk to your doctor before starting any exercise program. You need to create a safe workout if you already have weakened bones.
   • If you have weak bones, avoid twisting your spine and doing high-impact activities like running, jumping, or jogging.
3. Eat what calcium-rich foods you can. If you can tolerate it, drink milk and eat dairy products. These are rich in calcium. Unfortunately, many people with Crohn’s disease are lactose intolerant or experience symptoms when they eat dairy. In that case, incorporate whatever calcium-rich foods you can into your regular diet, such as:
   • Dark green leafy vegetables like kale and broccoli
   • Sardines and canned salmon
   • Products that are calcium-fortified including soy, cereal, fruit juice, and milk substitutes
4. Get as much vitamin D from your diet as you can. Regularly eat milk, cereal, and other products that are fortified with vitamin D. Egg yolks contain small amounts of vitamin D, so try to eat whole eggs. Snack on canned salmon or sardines – fish that have soft, edible bones.
5. Work with a dietician. Ask your doctor to refer you to a registered dietician. They can help you create meal plans that include the nutrients you need to maintain strong bones. Some dieticians are specially trained to work with people with Crohn’s and other diseases.
6. Get some sun. Spend around 10-30 minutes in the sun without sunscreen twice a week. Let the skin of your arms, legs, chest, and back soak up the rays. Sunlight helps your body make vitamin D.
   • You should not, however, get sunburned. If you have fair skin or burn easily, limit your time in the sun without sunscreen to 10 minutes or less. If you have darker skin, you can stay out for up to 30 minutes.
   • If you live in a cold climate, get what sunlight you can by sitting near a bright window.

Keeping Track of Your Bone Density

1. Work closely with your doctor. Crohn’s disease is a serious illness that can affect many parts of your body. It’s important to work closely with your doctor or even a specialist called a gastroenterologist. They can help you manage your symptoms, treat pain, and avoid complications of the disease including osteoporosis and bone fractures. Always take your medications as prescribed by your healthcare provider.
   • A common treatment for Crohn’s, corticosteroids, can also cause osteoporosis.
2. Have diagnostic blood tests done. Ask your doctor to check your levels of calcium and vitamin D. These are two very important minerals for bone health. This can be done with a simple blood test. These levels are often low in people who have Crohn’s disease.
3. Test your bone density. Consider getting a test done to test the density of your bones. This will show whether you have strong or weak bones from osteoporosis. It may help you and your doctor know how to manage your condition.
   • This test is similar to an x-ray. It is painless and only takes about 15 minutes to complete.

Sources and Citations

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