Irritable Bowel Syndrome and Osteoporosis

Pam Flores Health Guide April 15, 2010
  • April is Irritable Bowel Syndrome Awareness Month, so we'd like to discuss this disorder and its connection to osteoporosis.


    One in five people suffer from irritable bowel syndrome (IBS), and approximately 30-60% of those with IBS also have osteoporosis.


    What is IBS?


    According to the National Digestive Diseases Information Clearinghouse, Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances (NIH Publication No. 07-693, September 2007).


    Researchers have yet to discover any specific cause for IBS. One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. The immune system, which fights infection, may also be involved (NIH Publication No. 07-693, September 2007).


    Symptoms of IBS

    • Diarrhea, frequent and painful
    • Constipation chronic, frequent and painful 
    • Abdominal pain after a meal
    • Abdominal pain which is relieved only after a bowel movement
    • Abdominal pain which seems to come and go without explanation
    • Abdominal fullness, gas, bloating
    • Abdominal distention, nausea, vomiting
    • Loss of appetite
    • Emotional distress
    • Depression

    How is IBS Treated?

    • Dietary changes
    • Stress management and Exercise
    • Fiber supplements
    • Antidiarrhea medications like Lomotil and Imodium
    • Antispasmodics
    • Antidepressants (Selective Serotonin Reuptake Inhibitors)
    • Lotronex (this medication is intended for severe IBS, and the FDA has stringent restrictions on its use). For those taking this medication, consult with your doctor on its use since it can cause worsening of constipation and limited blood flow to the colon.
    • Muscle relaxers like Donnapine and Librax to minimize muscle spasms of the intestines, colon and bladder.

    Stressor's Connected to IBS


    Stress can cause spasms of the colon and intestines, so stress management is very helpful in this situation. You're probably familiar with the butterflies or stomach upset one experiences in stressful situations, this is an example of how your colon, which is controlled by your autonomic system, works in sending stress signals to your brain and in turn causes spasms in your colon.


    How is Osteoporosis Connected to IBS?


    The medications - like SSRI antidepressants - used to treat IBS, also cause bone loss. There's also a connection between the amount of serotonin that is produced in your stomach and osteoporosis. Over production of gut-derived serotonin, also causes bone loss.


    If you take an oral osteoporosis medication, you may not absorb it well with IBS, because it can pass through the intestines before being absorbed and then it's excreted through the bowels before it has a chance to work.


  • If you have both of these disorders, discuss your treatment options with your doctor. Since you may have to take some of the above medications that cause bone loss, find out what you and your doctor can do to limit the affects these medications have on bone loss. If you are able to control your IBS through stress management, exercise and dietary changes, then you may be able to avoid the medications used to treat IBS that cause bone loss.


    Additional Resources:


    Article on a new study of gut-derived serotonin-inhibitor LP533401 for irritable bowel syndrome and osteoporosis treatment.