Classification
1. Primary osteoporosis
Primary osteoporosis is often attacked the post-menopausal women and also in elderly men with unknown cause.
2. Secondary osteoporosis
Whereas secondary osteoporosis caused by diseases related to:
• Cushing's disease
• Hyperthyroidism
• Hyperparathyroidism
• Hypogonadism
• Liver disorders
• Chronic Renal Failure
• Lack of motion
• drinking alcohol
• Medicine users / corticosteroid
• Excess caffeine
• Smoking
Causes
Postmenopausal osteoporosis occurs because of lack of estrogen (the main hormone in women), who helped arrange the transport of calcium into bone in women. Usually symptoms occur in women aged between 51-75 years old, but could begin to emerge more quickly or more slowly. Not all women have the same risk for suffering from postmenopausal osteoporosis, a white woman and eastern regions suffering from a disease easier than black women.
Osteoporosis senilis likely the result of calcium deficiency related to age and the imbalance between the rate of bone destruction and new bone formation. Senilis means that this situation only occurs in old age. This disease usually occurs at age 70 years and above 2 times more likely to attack women. Women often suffer senilis and postmenopausal osteoporosis.
Less than 5% of those with osteoporosis, secondary osteoporosis is caused by another medical condition or by drug-obatan.Penyakit this can be caused by chronic renal failure and hormonal disorders (especially thyroid, parathyroid and adrenal) and drugs (eg corticosteroids, barbiturates, anti-seizure and excessive thyroid hormone). Excessive alcohol consumption and smoking can aggravate this situation.
Juvenile idiopathic osteoporosis is the cause of osteoporosis is unknown. This occurs in children and young adults who have hormone levels and normal function, normal levels of vitamins and has no obvious cause of bone fragility.
Symptoms
Bone density decreases slowly (especially in people with osteoporosis senilis), which at first caused no symptoms of osteoporosis. Some patients have no symptoms.
If bone density is reduced so that the bones be collapsed or destroyed, it will arise bone pain and deformity.
Vertebral collapse causing chronic back pain. Fragile spine may spontaneously collapses or because of minor injuries. Usually the pain arises suddenly and is felt in certain areas of the back, which will increase the pain if the patient was standing or walking. If touched, the area will be sore, but usually this pain will disappear gradually after several weeks or several months. If some broken spine, it will form an abnormal curvature of the spine (Dowager's hump), which causes muscle tension and pain.
Other bones can break, which is often caused by a mild pressure or a fall. One of the fractures of the most serious was a broken hip. What also often happens is a broken arm bone (radius) in the area with wrist connection, called Colles fracture. In addition, in people with osteoporosis, fractures tend to heal slowly.
Diagnosis
To someone who had fractures, the diagnosis of osteoporosis is established based on symptoms, physical examination and bone X-rays. Further tests may be needed to eliminate other conditions that can be overcome, which can cause osteoporosis.
To diagnose osteoporosis before fractures occur examination that assess bone density. The most accurate examination is DXA (dual-energy x-ray absorptiometry). This examination is safe and painless, can be done within 5-15 minutes. DXA is useful for:
• women who have a high risk of suffering from osteoporosis
• patients the diagnosis is uncertain
• treatment of patients must be assessed accurately.
Treatment
The purpose of treatment is to increase bone density. All women, especially those suffering from osteoporosis, should consume calcium and vitamin D in sufficient quantity.
Post-menopausal women suffering from osteoporosis can also get estrogen (usually together with progesterone) or alendronat, which can slow or stop the disease. Bisphosphonates are also used to treat osteoporosis.
Alendronat functions:
• reduce the speed of absorption of bone in postmenopausal women
• improve the bone mass in the spine and hip bone
• reduce the incidence of bone fractures.
To be well absorbed, alendronat should be taken with a full glass of water in the morning and within 30 minutes afterwards should not eat or drink something else. Alendronat can irritate the lining of the digestive tract, so that after drinking it should not be lying, at least for 30 minutes afterward. This drug should not be given to those who have difficulty swallowing or esophagus and stomach disease specific.
Calcitonin is recommended to be given to people who suffer from spinal fractures that are accompanied by pain. This drug can be given in the form of an injection or nasal spray.
Additional fluoride can increase bone density. But bone disorders can experience and become brittle, so its use is not recommended.
Men who suffer from osteoporosis usually get extra calcium and vitamin D, especially if the results indicate that the body does not absorb calcium in sufficient quantity. If low testosterone levels, testosterone can be given.
Fractures due to osteoporosis should be treated. Hip fractures are usually treated with surgery. Wrist fractures are usually repaired with a cast or surgery. In spinal collapse with a great back pain, given pain medication, supportive back brace fitted and physical therapy.
Prevention
Osteoporosis prevention includes:
• Maintain or increase bone density by consuming adequate calcium
• Conducting sports with weight
• Taking medications (for certain people).
Consuming calcium in sufficient amounts is very effective, especially before achieving maximum bone density (approximately age 30 years). Drink 2 cups of milk and vitamin D every day, can increase bone density in middle-aged women who previously did not get enough calcium. We recommend that all women take calcium tablets every day, the recommended daily dose is 1.5 grams of calcium.
Load exercise (e.g. walking and climbing stairs) would increase bone density. Swimming did not increase bone density.
Estrogen helps maintain bone density in women and is often taken in conjunction with progesterone. Estrogen replacement therapy is most effective starting in 4-6 years after menopause, but if it begins more than 6 years after menopause, can slow bone fragility and reduce the risk of fractures. Raloksifen an estrogen-like drugs the new, which may be less effective than estrogen in preventing bone fragility, but has no effect on the breast or uterus. To prevent osteoporosis, bisfosfonat (e.g. alendronat), can be used alone or in conjunction with hormone replacement therapy.
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