Alternate day dosing does not protect bone. Doctors should seek alternatives to steroid therapy, but if there is no other option, patients on steroids should be monitored closely for bone loss. Weight-bearing exercise, and eliminating smoking and excessive alcohol are important to preventing bone loss as well. Dr. Cohen reviewed the medical options for preventing and treating osteoporosis. It's clear from randomized clinical trials that biphosphonates are effective.
Compliance is poor, however.
You have to take these drugs with a full glass of water, sitting up, and they have been shown to cause esophageal irritation and ulcers. Diseases that involve such complications can tax patients emotionally. The psychological aspects of IBD were discussed by Douglas A. Drossman, M.D., Professor of Medicine and Psychiatry at the University of North Carolina, Chapel Hill. A person with IBD can have minimal inflammation, but be in severe pain. Or, you can see a patient with much disease activity and no pain.