Bone abnormalities in gastrointestinal and hepatic disease

Bone is a dynamic tissue that undergoes constant remodeling in response to local and environmental stimuli. Bone mass is maintained by this delicate equilibrium between bone formation and bone resorption. In growing children, the balance is tilted toward bone formation until peak bone mass is achieved in the second decade of life. Alterations in bone metabolism can result in decreased bone mass (osteopenia and osteoporosis) or impaired mineralization of the bone protein matrix (rickets and osteomalacia). Diseases of the alimentary tract such as celiac disease, inflammatory bowel diseases, gastrectomy, cholestatic liver diseases, liver transplantation, and hepatitis C can affect bone mineralization, remodeling, or bone mass. This article presents a summary of recent reports concerning bone disorders associated with disorders of the liver and gastrointestinal tract.