Osteoporosis is making news these days. It is a disease that affects 10 million individuals in the United States. If you include those with low bone mass, a precursor to full-blown osteoporosis, that number increases to 34 million. Recent advances in the diagnosis of osteoporosis prove it to be the most common disease of human bone. A greater health concern is the statistic that 40% to 50% of women over 50 years old will experience an osteoporosis-related fracture in their lifetime. Of the 1.5 million fractures that occur in a year, 300,000 of those are hip fractures. Numbers like these may not translate into concern until one realizes that one in five who fracture a hip will die within the first year after the fracture and another 20% will be so incapacitated that they will require skilled nursing care in an extended care facility. It’s important that people at risk realize the potential complications and danger to their independence and lifestyle. Although silent in symptoms until a fracture occurs, millions are at risk. The good news is that because of medical advances and management of osteopenia and osteoporosis, these problems are not only preventable but they can also be effectively treated before something bad happens.

   Early detection and treatment of osteoporosis is the key. Awareness about the disease and its risk factors is the first step towards stopping fractures and complications due to diminishing bone density. All women over the age of 65 should have a bone density study. All women, who are postmenopausal, should have a bone density study if they have one of the risk factors for osteoporosis. Risk factors include a family history of osteoporosis or a previous fracture, being Caucasian or Asian, having a small frame, living a sedentary lifestyle or the lack exercise, taking specific medications like cortisone and some blood thinners, smoking, high alcohol use and low calcium or vitamin D intake. An overactive parathyroid gland can cause osteoporosis as well so it’s important to diagnose the cause of the bone loss. Osteoporosis is more common in women; however, the condition in men is now being defined. The number of men who have osteoporosis is greater than was imagined just a few years ago.

   Once osteoporosis is diagnosed, treatment options include a class of medications known as the bisphosphonates. Oral representatives of this group are risedronate (Actonel) and alendronate (Fosamax). These medications can be taken daily or weekly. To be an effective agent to prevent and treat the disease, the medication must be taken exactly as directed. (Take the medication in the morning on an empty stomach with a full glass of water, remain upright and do not eat or take any other medication for at least 30 minutes). Gastrointestinal intolerance is the most frequent complaint. A study published by Lanza et al in the journal, Gastroenterology (September 2000) showed that risedronate (Actonel) was associated with fewer gastric ulcers than the alendronate treated group. These ulcers were identified by endoscopy. The authors did not, however, address the frequency of GI symptoms, that is, what the patient feels. The same group further studied the relative frequency of ulcers in those using risedronate and alendronate treated individuals who were infected with Helicobacter pylori, a bacterium known to cause gastric ulcers. This study, published recently in the Journal of Rheumatology, again demonstrated that the risedronate-treated group had fewer gastric ulcers than the alendronate group in patients with or without H. pylori infection. From these data it can be suggested that an individual being treated for or having previously suffered from a gastric ulcer should have any new persistent gastrointestinal symptoms evaluated and that there is a clear difference in the risk when comparing risedronate and alendronate.
  Osteoporosis is not a natural part of aging. It is a condition that causes your body to lose bone at a faster rate than it is replaced. Appropriate intake of calcium, vitamin D and exercising are critical for maintaining bone health, but they may not be enough to prevent osteoporosis. Talk with your doctor about where you stand regarding your bone health and the options available for prevention and treatment.

ABOUT WARREN RIZZO, M.D.
Dr. Warren Rizzo received his medical degree from the Universita Degli Study di Padova near Venice, Italy. He completed his residency in Internal Medicine from Mercy Catholic Medical Center in Darby, Pennsylvania and a fellowship in Rheumatology at Temple University Hospital in Philadelphia, Pennsylvania. He then spent ten years in the Air Force and two years as an Assistant Professor at The University of Iowa. Dr. Rizzo is board certified in Internal Medicine as well as in Rheumatology, and a fellow of the American College of Rheumatology. He is in private practice in Scottsdale, Arizona.

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