How Crohn's Disease Can Affect Your Bone Health

Crohn's disease affects the gastrointestinal tract and is a form of inflammatory bowel disease (IBD). It is characterized by inflammation in any part of the digestive system but usually affects the small intestine (via the Mayo Clinic). The main cause of Crohn's disease is not fully understood, although it may be hereditary in certain cases. The condition can also be triggered by an illness, as it is thought that in trying to fight off the virus or bacteria, the immune system mistakenly attacks healthy tissues in the digestive tract, leading to inflammation and damage.

Living with Crohn's disease can be challenging and may significantly impact a person's quality of life. Symptoms of the condition can vary from person to person and can come and go over time. One of the most common symptoms is pain, often located in the lower right side of the abdomen. Other symptoms include cramping, diarrhea, fatigue, blood in the stool, and weight loss. While the disease primarily affects the digestive system, it can also significantly affect bone health.

According to the Crohn's & Colitis Foundation, an estimated 30% to 60% of people with Crohn's disease have low bone density. One way the condition can negatively affect bone health is through the malabsorption of key nutrients, particularly vitamin D and calcium — both of which are essential for bone health. Vitamin D helps your body soak up calcium and is absorbed into your body through your small intestine. But because the small intestine is often compromised in a condition like Crohn's, this can lead to reduced absorption of both vitamin D and calcium, which can ultimately lead to bone loss or other conditions like osteoporosis.

Another factor that can negatively impact bone health in Crohn's disease is the use of corticosteroids. According to the Royal Osteoporosis Society, corticosteroids are a common treatment for IBD conditions like Crohn's. They can negatively affect bone health, however, as they may reduce bone density and increase the risk of fractures. The risk is particularly pronounced in people who take high doses of corticosteroids or who take them for extended periods. The chronic inflammation that is associated with Crohn's disease can also negatively affect bone health, as it can interrupt the natural cycle of bone growth, per the Crohn's & Colitis Foundation.

Maintaining good bone health can be challenging for people with Crohn's disease due to reduced nutrient absorption and medications that can negatively affect bone density. However, there are various strategies that can be employed. Ensuring adequate intake of calcium and vitamin D through diet or supplementation is important, according to the Crohn's & Colitis Foundation. Speak to your doctor about which supplements you can take to ensure adequate nutrient intake. 

Vitamin D can also be obtained through sunlight exposure or dietary sources such as fish and fortified dairy products, per WebMD. Other dietary changes may be needed to help reduce inflammation. Some foods — such as processed foods and refined sugars — can increase inflammation in the body, while others — such as fruits, vegetables, and whole grains — have anti-inflammatory properties (via Healthline).

The Crohn's & Colitis Foundation also advises minimizing the use of corticosteroids. People taking corticosteroids should work with their healthcare provider to use the lowest effective dose. Stopping smoking, reducing alcohol intake, and exercising regularly can also help support bone health.