What is osteoporosis and why does it occur

Published: 2019-08-30 07:00:00
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According to World Health Organization (WHO), Osteoporosis is a disease that is defined by a decreased mass of the bones, and micro-architectural deterioration of the tissues of the bones. It causes the bones to be fragile increasing the risk of fracturing. Similarly, osteoporosis can be defined as a decrease in the volume to volume ratio as observed from an iliac crest bone biopsy. In this case, the extent of osteoporosis is taken as the ratio of bone volume to total volume (BCG, 2015).

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Herdman & Paul (2005) defines osteoporosis as the disease that makes the bones fragile and more susceptible to breakage. The three key defining symptoms that cause the disease are a low mass of the bone, a structural deteriorating of the bone tissue which leads to an increase in fragility and susceptibility to fracturing, especially of the hip, the spine, and the wrist bone.

Bone Remodeling

It is the process that maintains the bone mass. The process involves the continuous breaking down and re-formation of the bones (Afghani, 2011). Several hormones control this process. Osteoclasts cells perform the breakdown procedure by consistent removal of tiny microscopic portions at the edge of the surface of the bone. The immediate osteoblasts cells carry out the replacement procedures. During young adulthood, the rate of bone removal equals the rate of bone replacement. Therefore, bone remodeling is constant. However, with age, there is an imbalance created where the amount of bone tissue equals the difference between the amount of bone tissue accumulated during growth/consolidation and bone tissue lost due to aging.

Menopausal effect of bone mineral density: the physiological process.

When women undergo the early menopause, they experience a significant decrease of hormone estrogen circulating in the body system. As a result, the rate of bone resorption increases. However, the rate of bone reformation does not increase. Due to these changes, an imbalance is created which triggers the process of osteoporosis (Burckhardt, Heaney & Dawson-Hughes, 2007). Additionally, the hormonal changes and bone loss due to age happen as a result of failure to utilize calcium, a reduced absorption of vitamin D by the kidney. The bones release excessive calcium in the blood stream, hence lose their density as well as their hardness

The typical risk factors and symptoms of the disease and information necessary for diagnosis

Some risk factors may increase the predisposing of osteoporosis. Although some factors can be, modified others are inevitable. In the case of Mrs. C, a decrease in sex hormones, especially the low levels of estrogen after she undergoes menopause causes hormonal imbalances and triggers osteoporosis. Age is a risk factor whereby a person is more prone to osteoporosis with an increase in age. Genetics play a significant role in increasing the possibility of osteoporosis attacks. If parents have had histories of osteoporosis, then the family members in that line are more prone to fracture a bone in the future. The risk also tends to increase with people who had previously had a fracture when they underwent a low-level injury and particularly if the accident happened at the age of 50 and above. Lastly, the kind of a lifestyle person leads can also be a risky factor. This means that a person needs to be engaging in exercises that place a high degree of stress on the individuals bones for the bones to grow strong (Svec, 2003). Mrs. C typical day does not display healthy eating schedule because she consumes snacks with a diet that does not include dairy products like milk.

Diagnosis

While diagnosing osteoporosis, the only accurate way to affirm the presence of the disease is by the Measurement of Bone Mass Density (BMD). The reason is that osteoporosis is at times very silent and internal. An instrument called Dual-energy X-ray absorptiometry scan (DEXA) is used. The DEXA gives information such as the strength of the bones and the risk of fracturing (Stovall, 2013). For Mrs. C, who is postmenopausal, spine measurement is the most sensitive to predict her bone loss.

In the evaluation of the persons bone density, two scores are used: A Y-score and a Z-score. Mrs. C results would be given in the record of a T-score, which will be comparing her bone mass against the bone mass of a healthy person of a female at peak bone mass. If the results are positive, a lower score is expected, and this implies a higher risk of fracture. A score of -2.5 will imply osteoporosis

Treatment

Treatment can be done using anabolic medications such as Teriparatide (Forteo). The medicine aids in the treatment of osteoporosis (Smith, 2010). Also, osteoporosis can be treated using selective estrogen receptor modulators. An example is using Raloxifene, which has been approved for prevention and treatment of osteoporosis. Suppose the other medications have been contraindicated for not being tolerable with her system, administering Estrogens/ Hormones like Conjugated Estrogen (Premarin) would be used as the substitute. In addition, recommending the patient for bed rest can be helpful. The patient should start walking exercises strengthen her muscles more.

References

Afghani, A. (2011). Hypertension and bone loss. New York: Nova Biomedical/Nova Science Publishers.

BCG. (2015). Reactions Weekly, 1579(1), pp.73-73.

Burckhardt, P., Heaney, R. & Dawson-Hughes, B. (2007). Nutritional aspects of osteoporosis 2006. Amsterdam: Elsevier.

Herdman, A. & Paul, G. (2005). Pilates plus. London: Gaia.

Smith, P. (2010). What you must know about women's hormones. Garden City Park, NY: Square One Publishers.

Stovall, D. (2013). Osteoporosis. Chichester, England: Wiley-Blackwell.

Svec, C. (2003). The Inflammation Cure. McGraw-Hill Publishing.

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