Metabolic Bone Disease in Inflammatory Bowel Disease.

An oral calcium supplement (1000 mg/day) is recommended. Regular exercise should be performed. Ethanol intake should be moderate. Protein intake should be moderate. The patient's vitamin D status should be determined and corrected with an oral supplement when deficiency is present. Baseline and yearly bone density measurement should be taken. Alendronate, 10 mg/d orally, or risedronate, 5 mg/d orally, should be given to patients with osteopenia. Use of corticosteroids, cyclosporin, tacrolimus, and methotrexate should be limited to the short term when possible. Estrogen replacement therapy is recommended in postmenopausal women unless contraindications exist.