@laura1970 & Kelda: 15 years ago I started having a lot of abdominal distress. I won't get into the details but I lost 27 pounds in two years and wasn't trying to. I see an osteopath (that is NOT a chiropractor, by the way) regularly for my on-going back issues. He documented my weight loss. I was referred to a gastroenterologist and after having both a colonoscopy and an endoscopy I was diagnosed with celiac disease. (That explained a lot of problems throughout my life but won't go into that on this post.) I was referred to Stanford. The gastroenterologist there, who specialized in celiac disease, told me the tips of my small intestine villi were damaged and would never really rejuvenate. The tip is what digests lactose so I am now lactose intolerant as well as wheat, gluten, barley, rye intolerant. (The latter being from celiac disease.) Thank you for posting that ATELVIA bypasses the stomach and is absorbed through the small intestine. This would be a medicine I could never take as my small intestine is already compromised because of celiac disease. If bisphosphonates are known to cause stomach and esophageal irritation I would also worry about small intestine irritation/damage. The small intestine's primary function is to absorb the nutrients from digested food.