Diagnosis and management of iron deficiency anemia in patients with IBD

  title={Diagnosis and management of iron deficiency anemia in patients with IBD},
  author={J{\"u}rgen Stein and Franz Hartmann and Axel U Dignass},
  journal={Nature Reviews Gastroenterology \&Hepatology},
Anemia is the most prevalent extraintestinal complication of IBD. It can affect quality of life and ability to work, and can also increase the hospitalization rate in patients with IBD. Although the causes of anemia in IBD are multifactorial, iron deficiency anemia (IDA) is the most common. Assessment of the iron status of patients who have a condition associated with inflammation, such as IBD, by using common biochemical values is insufficient. However, new indices of iron metabolism (for… 

Management of iron deficiency anemia in inflammatory bowel disease – a practical approach

Improved diagnostic and therapeutic strategies based on new clinical insights into the regulation of iron homeostasis are discussed based on the wide availability of a variety of new IV preparations with improved safety profiles.

Diagnosis and treatment of anemia in patients with inflammatory bowel disease

Current understanding of anemia in IBD patients is summarized, including the underlying pathology, diagnostic approaches and appropriate anemia treatment regimens, which suggest it still remains underdiagnosed and undertreated.

Practical guidance for the management of iron deficiency in patients with inflammatory bowel disease

The aim of this review is to draw attention to the need for treatment for every level of anemia in patients with IBD and to provide some practical guidance for screening, diagnostics, treatment and follow up of IDA in patientswith IBD following current international guidelines.

Management of inflammatory bowel disease-related anemia and iron deficiency with specific reference to the role of intravenous iron in current practice

While traditional oral iron preparations are associated with increased inflammation, negative effects on the microbiome, and poor tolerance and compliance, first clinical trial data indicate that newer oral compounds such as ferric maltol and sucrosomial iron offer improved tolerability and may thus offer a viable alternative for the future.

Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

Oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency anemia unless such patients are intolerant or have an inadequate response, whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron.

Anemia in inflammatory bowel disease: a neglected issue with relevant effects.

The management of anemia is a complex aspect of treating IBD patients, one that significantly influences the prognosis of the disease and should be considered a specific, first-line therapeutic goal in the management of these patients.

Iron deficiency anemia in IBD: an overlooked comorbidity

The aim in this review is to provide apathway for physicians to help them diagnose and appropriately treat Iron Deficiency Anemia in IBD and proposed new directions on how future research can help manage IDA in I BD effectively.

Diagnosis and treatment of anemia in patients with infl ammatory bowel disease

This review summarizes the current understanding of anemia in IBD patients, including the underlying pathology, diagnostic approaches and appropriate anemia treatment regimens, and suggests that it still remains underdiagnosed and undertreated.



Ferritin as a simple indicator of iron deficiency in anemic IBD patients.

This study verified whether a comparable assessment could be obtained just by setting optimal decision limits of other routine laboratory tests in anemic and nonanemic IBD patients and established the sensitivity and specificity of conventional laboratory tests of iron status.

Common Misconceptions in the Diagnosis and Management of Anemia in Inflammatory Bowel Disease

There is enough evidence to support the following statements: anemia is very common in IBD, anemia should be investigated with care because many factors can be responsible, treatment of anemia results in clear improvement in the objective parameters of well-being, especially in the quality of life, and IV iron is safe and effective in the treatment of iron deficiency anemia in I BD patients.

Rapid Recurrence of IBD-Associated Anemia and Iron Deficiency After Intravenous Iron Sucrose and Erythropoietin Treatment

IBD-associated ID and anemia recur surprisingly fast, indicating that maintenance treatment may be needed in a portion of the patient population, and recurrence of ID (but not anemia) can be delayed by aiming for high post-treatment ferritin levels.

Iron deficiency anemia: diagnosis and management

  • S. F. Clark
  • Medicine
    Current opinion in gastroenterology
  • 2009
Best practice guidelines for diagnosing and managing IDA should include the design of an algorithm that is inclusive of multiple biomarkers and cause-based diagnostics, which will provide direction in managingIDA, and distinguish between IDA from the anemia of chronic disease.

Effects of changes in hemoglobin level on quality of life and cognitive function in inflammatory bowel disease patients

Treatment of IBD‐associated anemia with iron may lead to improvement in patients' QOL, and increases in Hb improved QOL scores in IBD patients independent of change in disease activity.

Evaluation and Treatment of Iron Deficiency Anemia: A Gastroenterological Perspective

Data is provided supporting the use of the serum ferritin as the sole useful measure of iron stores, setting the lower limit at 100 μg/l for some populations in order to increase the effectiveness of the test.

Intravenous Iron and Erythropoietin for Anemia Associated with Crohn Disease

Recombinant human erythropoietin was studied in a controlled trial of patients with anemia refractory to oral iron treatment and the effect of the treatment of anemia on quality of life was investigated.

Impaired intestinal iron absorption in Crohn's disease correlates with disease activity and markers of inflammation

Subjects with active CD have impaired oral iron absorption and elevated IL‐6 levels compared with subjects with inactive disease, suggesting that oral iron may be of limited benefit to these patients.

Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases.

Recommendations are made regarding diagnostic measures to screen for iron- and other anemia-related deficiencies regarding the triggers for medical intervention, treatment goals, and appropriate therapies.

Prediction of response to iron sucrose in inflammatory bowel disease-associated anemia

Serum erythropoietin, sTfR, and transferrin concentrations have the potential to predict the response to iron sucrose therapy in IBD-associated anemia, and these parameters may help to identify individuals who benefit the most from additional erymorphological treatment.