Prevalence and risk factors for low bone mineral density in ulcerative colitis

Rapid and relaying deleterious effects of a gastrointestinal pathogen, Citrobacter rodentium, on bone, an extra-intestinal organ

Enteropathogenic infections cause pathophysiological changes in the host but their effects beyond the gastrointestinal tract are undefined. Here, using Citrobacter rodentium infection in mouse, which mimics human diarrheal enteropathogenic Escherichia coli, we show that gastrointestinal infection negatively affects bone remodeling, leading to compromised bone architecture. Transmission of infection through fecal-oral route from Citrobacter rodentium-infected to non-infected mice caused bone loss in non-infected cage mates. Mice with B cell deficiency (Igh6-/- mice) failed to clear C. rodentium infection and exhibited more severe and long-term bone loss compared to WT mice. Unbiased cytokine profiling showed an increase in circulating tumor necrosis factor α (TNFα) levels following Citrobacter rodentium infection, and immunoneutralization of TNFα prevented infection-induced bone loss completely in WT and immunocompromised mice. These findings reveal rapid, relaying, and modifiable effects of enteropathogenic infections on an extraintestinal organ-bone, and provide insights into the mechanism(s) through which these infections affect extraintestinal organ homeostasis.

Nutritional screening and assessment in inflammatory bowel disease

Inflammatory bowel disease (IBD) is associated with increased risk of malnutrition and sarcopenia. Both malnutrition and sarcopenia negatively impact the clinical course, quality of life, response to therapy, and surgical outcomes in patients with IBD. This review article highlights the importance of nutritional assessment in patients with IBD and also discusses the different nutritional screening and assessment tools, and measures to detect sarcopenia in relation to IBD. Identification of malnutrition and sarcopenia will allow prioritization of the corrective actions, such as nutritional rehabilitation, to improve clinical outcomes. An approach to the evaluation of nutritional status in patients with IBD is also suggested.

Imaging in the Assessment of Musculoskeletal Manifestations Associated with Inflammatory Bowel Disease

Extraintestinal manifestations are the cause of morbidity and affect the quality of life of patients with inflammatory bowel diseases (IBDs). Musculoskeletal manifestations, in particular, spondyloarthritis and osteoporosis, are the most frequent extraintestinal manifestation of IBDs. The diagnosis and management of the musculoskeletal manifestation of IBDs relies on imaging. Conventional radiography, magnetic resonance imaging, computed tomography, and ultrasound can help to detect pathological signs of spondyloarthritis, both peripheral and with axial involvement. Dual-energy X-ray absorptiometry is the gold standard for identifying the presence of osteoporosis, whereas conventional radiology and computed tomography can reveal occult vertebral fractures. The aim of this narrative review is to describe the imaging of musculoskeletal manifestations of IBDs.