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

2018 ◽  
Vol 11 ◽  
pp. 175628481876907 ◽  
Author(s):  
Dorothea Niepel ◽  
Thomas Klag ◽  
Nisar P. Malek ◽  
Jan Wehkamp
Keyword(s):  
Iron Deficiency ◽  
Treatment Options ◽  
Intravenous Iron ◽  
Underlying Disease ◽  
Deficiency Anemia ◽  
Diagnostic Tools ◽  
Systemic Complications ◽  
Need For Treatment ◽  
Inflammatory Bowel ◽  
Practical Guidance

Iron deficiency or iron deficiency anemia (IDA) are some of the most common systemic complications of inflammatory bowel diseases (IBD). Symptoms such as fatigue, reduced ability to concentrate and reduced exercise tolerance can mimic common symptoms of IBD and can therefore easily be overseen. Furthermore, clinicians tend to see mild to moderate anemia as an inevitable accompaniment of IBD that is sufficiently explained by the underlying disease and does not require further workup. But in contrast to these clinical routines, current guidelines recommend that any degree of anemia in patients with IBD should be further evaluated and treated. Multiple studies have shown that anemia is a main factor for decreased quality of life (QoL) in patients with IBD. Correction of anemia, however, can significantly improve the QoL of patients with IBD. It is therefore recommended that every patient with IBD is regularly screened for iron deficiency and anemia. If detected, appropriate workup and treatment should be initiated. Over the last years, a number of new diagnostic tools and treatment options have been developed. Multiple studies have demonstrated the safety of newer formulations of intravenous iron in patients with IBD and have compared oral and intravenous iron in various situations. Treatment recommendations have changed and new evidence-based guidelines were developed. However, to date these guidelines are still not widely implemented in clinical practice. 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 patients with IBD following current international guidelines.

scholarly journals Safety and Efficacy of Intravenous Iron Sucrose for Iron-Deficiency Anemia in Children and Adolescents With Inflammatory Bowel Disease

2019 ◽  
Vol 6 ◽  
pp. 2333794X1987098
Author(s):  
Ramy Sabe ◽  
Anant Vatsayan ◽  
Amr Mahran ◽  
Ali S. Khalili ◽  
Sanjay Ahuja ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Bowel Disease ◽  
Intravenous Iron ◽  
Iron Sucrose ◽  
Deficiency Anemia ◽  
Safety And Efficacy ◽  
Normal Ranges ◽  
Inflammatory Bowel

Background. Anemia is common in inflammatory bowel disease (IBD). Oral iron is widely used but efficacy can be reduced by poor compliance and insufficient absorption. Intravenous iron is safe and effective in adults but is not well studied in children. Purpose. To assess safety and efficacy of intravenous iron sucrose (IVIS) in children with IBD. Methods. We reviewed medical records of IBD patients <22 years of age who received IVIS at our institution between 2009 and 2014. Anemia was defined as hemoglobin (Hgb) level below normal for age and gender and iron-deficiency anemia as serum iron studies and red cell mean corpuscular volume below normal ranges. Each IVIS infusion was evaluated for safety. Efficacy was defined as ≥2 g/dL increase in Hgb ≤12 weeks from IVIS initiation. Results. We identified 88 patients (Crohn’s disease, n = 52; ulcerative colitis, n = 33; IBD-unclassified, n = 3) who underwent 329 IVIS infusions over 121 courses. No patient developed anaphylaxis. Six patients developed minor adverse reactions. Of the 121 IVIS courses, 80 were included in the efficacy evaluation. There was a significant rise in Hgb (mean 9.1 ±1.4 to 11.9 ± 1.8 g/dL; P < .0001, paired t test). Overall, 58.7% (47/80 courses) resulted in goal Hgb increase. Conclusions. IVIS is safe and effective in treating iron-deficiency anemia in pediatric IBD. There were only minor adverse events, and the observed rise in Hgb was clinically significant, with the majority achieving goal Hgb.

scholarly journals Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4008
Author(s):  
Dagmara Mahadea ◽  
Ewelina Adamczewska ◽  
Alicja Ewa Ratajczak ◽  
Anna Maria Rychter ◽  
Agnieszka Zawada ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Supplementation ◽  
Clinical Symptoms ◽  
Intravenous Iron ◽  
Chronic Fatigue ◽  
Deficiency Anemia ◽  
Surgical Removal ◽  
Adequate Treatment ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract. IBD has been associated with numerous symptoms and complications, with the most common being iron deficiency anemia (IDA). Iron deficiency in IBD is caused by inadequate intake, malabsorption (including duodenal involvement and surgical removal), and chronic blood loss by mucosal ulcerations. Therefore, an appropriate diet should be enforced. Iron deficiency and iron supplementation have been associated with alterations to gut microbiota. IBD-associated anemia, in particular iron deficiency anemia, is associated with a significant decrease in quality of life and with clinical symptoms such as chronic fatigue, headaches and dizziness, reduced exercise tolerance, pale skin, nails, conjunctiva, and fainting. However, despite these numerous adverse symptoms, IDA remains undertreated. The European Crohn’s and Colitis Organisation (ECCO) guidelines state that patients should be monitored for anemia. Adequate treatment, whether oral or intravenous, should be implemented while taking into consideration C-reactive protein values (CRP), hemoglobin levels, and therapeutic response. It should be stressed that every case of anemia in IBD patients should be treated. Intravenous iron formulations, which are more superior compared to the oral form, should be used. There is a need to increase awareness and implementation of international guidelines on iron supplementation in patients with IBD.

scholarly journals High Dose Intravenous Iron Carboximaltose: A Safe, Efficacy and Simple Therapy to Treat Iron Deficiency Anemia in Inflammatory Bowel Disease

2011 ◽  
Vol 140 (5) ◽  
pp. S-446
Author(s):  
Fernando Gomollon ◽  
Erika J. Garza ◽  
Jose A. Garcia Erce ◽  
Sonia Gallego Montañes ◽  
Isabel Calvo Morillas ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Bowel Disease ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
High Dose ◽  
Inflammatory Bowel

scholarly journals Gastroenterologist-Lead Management of Iron Deficiency Anemia in Inflammatory Bowel Disease Is Effective, Safe, and May Increase Quality of Life

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Christopher L Coe ◽  
Matthew H Meyers ◽  
Dawn B Beaulieu ◽  
Elizabeth Scoville ◽  
David A Schwartz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Bowel Disease ◽  
Retrospective Chart Review ◽  
Intravenous Iron ◽  
Deficiency Anemia ◽  
Inflammatory Bowel

Abstract Background The effectiveness and safety of gastroenterologist (GI)-lead treatment of iron deficiency anemia (IDA) in inflammatory bowel disease (IBD) have not been well-studied. Methods A retrospective chart review of patients with IBD, IDA, and evidence of treatment with iron at a tertiary IBD center was conducted. Results In 351 patients, hemoglobin and quality of life scores increased significantly after treatment with iron. Twelve of 341 patients treated with intravenous iron had an adverse effect. Twenty-seven patients required a hematology referral. Conclusion GIs should consider treating patients with IBD and IDA with intravenous iron as it is safe and effective.

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