Management of bone health in patients with celiac disease: Practical guide for clinicians.

OBJECTIVE: To describe clinical issues related to bone health in patients with celiac disease (CD) and to provide guidance on monitoring bone health in these patients. SOURCES OF INFORMATION: A PubMed search was conducted to review literature relevant to CD and bone health, including guidelines published by professional gastroenterological organizations. MAIN MESSAGE: Bone health can be negatively affected in both adults and children with CD owing to the inflammatory process and malabsorption of calcium and vitamin D. Most adults with symptomatic CD at diagnosis have low bone mass. Bone mineral density should be tested at diagnosis and at follow-up, especially in adult patients. Vitamin D levels should be measured at diagnosis and annually until they are normal. In addition to a strict gluten-free diet, supplementation with calcium and vitamin D should be provided and weight-bearing exercises encouraged.
CONCLUSION: Bone health can be adversely affected in patients with CD. These patients require adequate calcium and vitamin D supplementation, as well as monitoring of vitamin D levels and bone mineral density with regular follow-up to help prevent osteoporosis and fractures. Copyright© the College of Family Physicians of Canada.