W1135 High Incidence of Osteoporosis in Patients Over 50 Following Restorative Proctocolectomy Suggests Need for Routine Dxa Screening

Abstract

Background: The incidence of osteoporosis in IBD patients is 14%. Corticosteroids and age are known risk factors. The current AGA guidelines(1) do not recommend performing DXA in patients following restorative proctocolectomy (RPC) for ulcerative colitis. Some studies have suggested that bone density may increase following RPC, however there are no studies of bone density in patients over 50. We hypothesised that following RPC patients over 50 would be at increased risk since they are likely to have had worse disease and received higher doses of corticosteroids than an average population of UC patients. We sought to establish whether DXA should be routinely performed in this group. Method: All RPC patients over 50 seen in an outpatient clinic from August 2006 to August 2007 underwent a DXA bone scan of the hip and vertebral spine unless recently performed. Osteoporosis and osteopenia were diagnosed according to the WHO definitions. The hospital notes were then reviewed. Results: 18% of all patients screened had osteoporosis present either at the hip or vertebral spine. 44% of all patients had osteopenia. Further details are given in Table 1. Conclusion: The results of this study reveal that osteopenia and osteoporosis in RPC patients over 50 is at least as common as that in the general UC population. We therefore recommend that the standard AGA guidelines for osteoporosis screening should be extended to include RPC patients; the results of this study have important implications for clinical practice. Reference List (1) Bernstein CN et al. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology 2003;124(3):795-841. Table 1.