Which factor drives the need for osteoporosis screening in IBD patients on corticosteroids?

• A. Increased risk of osteoporosis
• B. Increased risk of kidney failure
• C. No effect on bone health
• D. Causes immediate tumor formation

Answer: (A)

Corticosteroids used in IBD directly harm bone health, making osteoporosis screening essential. These medications suppress bone formation by inhibiting osteoblast activity and promote bone resorption by increasing osteoclast activity. They also reduce calcium absorption from the gut and increase calcium loss in the urine, which lowers bone mineral density. Inflammation from IBD itself compounds this risk through cytokine-driven bone loss and potential nutritional deficiencies, so the combination markedly raises fracture risk. Screening with bone density testing (like a DEXA scan) helps detect osteoporosis early, enabling timely interventions such as calcium and vitamin D optimization, lifestyle measures, and osteoporosis-directed therapies to reduce fracture risk.

The other options don’t fit because corticosteroids, not kidney issues, are the primary driver of this risk; there is a real effect on bone health, and corticosteroids do not cause immediate tumor formation.