osteoporosis.docx

**Osteoporosis** Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means \"porous bones\"). Bone is made of tough, elastic fibres (collagen fibres) and gritty, hard material (minerals). It is a living tissue and contains cells that make, and take back up (resor...

**Osteoporosis** Osteoporosis is a condition that affects bone strength (the word osteoporosis literally means \"porous bones\"). Bone is made of tough, elastic fibres (collagen fibres) and gritty, hard material (minerals). It is a living tissue and contains cells that make, and take back up (resorb) bone. Initially, as you grow, bone forms faster than it is resorbed. But, as you get older, this reverses. As a result, from about the age of 35, you start to lose a certain amount of bone material overall. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss then you have \'thinning\' of the bones (osteoporosis). If you have osteoporosis, your bones can break more easily than normal, especially if you have an accident such as a fall. If you have a milder degree of bone loss, this is known as osteopenia. **[Who is at risk of osteoporosis?]** All men and women have some risk of developing \'thinning\' of the bones (osteoporosis) as they become older, particularly over the age of 60. women are more at risk than men. Risk factors: a woman especially those having menopause before the age of 45. Have already had a bone fracture after a minor fall or bump. Have a strong family history of osteoporosis (that is, a mother, father, sister or brother affected). Have a body mass index (BMI) of 19 or less (that is, very underweight). low estrogen level for long periods of time and, combined with a poor diet, this can affect bones. a steroid medicine (such as prednisolone) for three months or more. Aside effect of steroids is to cause bone loss. For example, long-term courses of steroids are sometimes needed to control arthritis or certain other conditions. smoking. alcohol intake. Lack calcium and/or vitamin D (due to a poor diet and/or little exposure to sunlight). poor mobility. For those using a wheelchair, or are confined to a bed or chair and unable to get about. certain medical conditions. Some conditions add to the risk of osteoporosis. For example: An overactive thyroid. Coeliac disease. Cushing\'s syndrome. Crohn\'s disease. Chronic kidney disease. Rheumatoid arthritis. Chronic liver disease. Type 1 diabetes. Any condition that causes poor mobility. **[Osteoporosis symptoms: ]** \'Thinning\' of the bones (osteoporosis) usually develops slowly over several years, without any symptoms. However, after a certain amount of bone loss, the following may occur: Abone fracture after a minor injury such as a fall. This is often the first sign or indication that you have osteoporosis. If you have osteoporosis, the force of a simple fall to the ground (from the height of a standard chair or less) is often enough to fracture a bone. Asimple fall to the ground such as this does not usually cause a fracture in someone without osteoporosis. Abone fracture after a minor injury like this is known as a fragility fracture. The most common fragility fractures occur in the hip, wrist and the bones that make up the spine (vertebrae). A fractured bone in an older person can have serious consequences in some people. For example, about half the people who have a hip fracture are unable to live independently afterwards because of permanent mobility problems. Having weaker bones does not in itself give you any symptoms. Unless you have had a fracture, aches and pains are NOT a symptom of osteoporosis. It does not cause pain other than as the result of a fracture. If you have not had a fracture and you have a pain, this will be due to another problem, not your osteoporosis. Having said that, fractures in the vertebrae are often not picked up. So if you have a new severe back pain and you know you have osteoporosis, you should tell your doctor. An X-ray can then be arranged to check you have not had a fracture. Loss of height, persistent back pain and a bent forward (stooping) posture. These symptoms can occur if you develop one or more fractured vertebrae. Avertebra affected by osteoporosis may fracture even without a fall or significant force on it. The vertebrae can become squashed following a fracture. If severe, a bent forward posture may affect your ability to go about your usual daily activities. It can also affect your breathing, as your lungs have less room to expand within your chest. **[How is osteoporosis diagnosed? ]** It can be diagnosed by DEXAscan. DEXA stands for dual-energy X-ray absorptiometry. It is a scan that uses special X-ray machines to check your bone density. ADEXAscan can confirm osteoporosis. After symptoms develop Osteoporosis is often first diagnosed when you break a bone after a minor bump or fall. Even after the first fracture has occurred, treatment can help to reduce your risk of further fractures. If you are thought to have sustained a fragility fracture, you will usually be referred for a DEXAscan to look for signs of osteoporosis. However, sometimes women of 75 or older who have a fracture are assumed to have had a fragility fracture. In this group of women, treatment for osteoporosis may be started without having a DEXAscan first. This is because osteoporosis is so common in this age group. Other tests Anewer test to look for osteoporosis is called digital X-ray radiogrammetry (DXR). It is easier to perform than a DEXAscan because it requires less technical equipment. It may sometimes be used as a screening test for osteoporosis - for example, in someone who has broken their wrist after a fall. However, it is not as sensitive as a DEXAscan at picking up all cases of osteoporosis. So, a DEXAscan remains the gold standard test. Ultrasound scans are also sometimes used as a screening test. They usually assess the bone at your heel. Again, they are not as sensitive as DEXAand not used very often. **[What can I do to prevent osteoporosis? ]** Exercise can help to prevent osteoporosis. Food rich with Calcium as milk, yougurt, dried fig and food rich with vitamin D as salmon, tuna fish. Vitamin D is mainly made by your body after exposure to the sun. The ultraviolet rays in sunshine trigger your skin to make vitamin D. Avoid Smoking and drinking alcohol. Hormone replacement therapy Hormone replacement therapy (HRT) contains oestrogen. But long term used of it may lead to small increased risk of breast cancer, heart disease and stroke Lifestyle measures and prevention of falls are important for all people with osteoporosis. This involves various things such as: Aphysical examination. Checking your vision, hearing and ability to walk. Reviewing your medication. Reviewing your home circumstances. Hip protectors may also help in some people. These are special protectors that you wear over your hips that aim to cushion your hips if you do have a fall. **[Medication for osteoporosis ]** Various medicines are available that can help to prevent and treat bone loss. Options used to treat \'thinning\' of the bones (osteoporosis) include the following. Bisphosphonates: Bisphosphonates are a group of medicines that include alendronate, risedronate and etidronate. They are the most commonly used medicines to treat osteoporosis. They work on the bone-making cells. They can help to restore some lost bone and help to prevent further bone loss. It should be taken whilst sitting up and with plenty of water, as they can cause irritation of oesophagus. This can lead to indigestion-type symptoms such as heartburn or difficulty swallowing. Other side-effects may include diarrhoea or constipation. Also, It should not take at the same time as food. You should not eat or take other tablets for half an hour after taking your bisphosphonate tablet. A rare side-effect from bisphosphonates is a condition called osteonecrosis of the jaw. This condition can result in severe damage to the jaw bone. In addition to plenty of calcium and vitamin D to make bone.