Vnitr Lek 1993, 39(2):125-131

[Secondary osteopenia in gastrointestinal diseases].

J Kocián: Institutu pro dalsí vzdĕlávání lékarů a farmaceutů Praha.

Of 2557 patients with osteopenia examined during the past 17 years 1707 were classified as secondary osteoporosis and 406 as osteomalacia. Diseases of the gastrointestinal tract participate as the cause of osteoporosis in 635 patients (37.19%) and osteomalacia was the cause in 210 patients (51.72%). The highest ratio in osteoporoses are lactose intolerance--256 cases (14.99%); maldigestion was recorded in 305 patients (17.86%). This category comprises gastrectomies of both types, severe affections of the gallbladder and biliary pathways, insufficiency of the external pancreatic secretion, patients with frequent exacerbations of ulcerative colitis. Resections of the small intestine are on the borderline between maldigestion and malabsorption. Malabsorption alone was found in 74 patients (4.33%) and there is also sprue, M. Crohn, diverticulosis of the small intestine, diabetic enteropathy and scleroderma. In secondary osteomalacia the leading cause is hepatic damage recorded in 167 patients (41.13%) and malabsorption in 43 patients (10.59%).