Magnesium and phosphate are also important for bone health. Magnesium absorption is a problem only in diffuse intestinal disease, or in combination with certain laxatives, and is not affected by vitamin D. Phosphate absorption is primarily regulated by the amount in the diet, but is also affected by vitamin D. Increased stool losses of these nutrients can occur whenever the food transit through the intestines is very rapid. Increased stool losses means less mineral or vitamin absorbed, leading to the same problems. Some of the medications used to treat inflammatory bowel disease complicate the problem of bone health. The largest problem occurs from one of the best medications, corticosteroids.
Corticosteroids are anti-inflammatory medications used to reduce tissue inflammation.
Examples include prednisone, prednisolone, dexamethasone, and intravenous solumedrol. All of these effects reduce bone density. The fastest loss of bone density actually occurs in the first six months on corticosteroids. The bone loss is cumulative, and most people who have been on corticosteroids for an extended period of time have reduced bone density. Some will develop problems with fractures.