Insights into the diagnosis and management of iron deficiency in inflammatory bowel disease

Expert Rev Hematol. 2017 Sep;10(9):801-808. doi: 10.1080/17474086.2017.1355233. Epub 2017 Jul 26.

Abstract

Iron deficiency is a frequent comorbidity of chronic diseases such as inflammatory bowel disease that can severely impact the health and quality of life of affected individuals. It can exist as a silent condition and manifest in non-specific symptoms even in the absence of anemia. Even though iron deficiency anemia is the most common complication and extra-intestinal manifestation of inflammatory bowel disease, the majority of inflammatory bowel disease patients who are diagnosed with iron deficiency anemia are not treated. Areas covered: In this review, we discuss iron deficiency and iron deficiency anemia in patients with inflammatory bowel disease, and review diagnostic and therapeutic options. Expert commentary: We invite international gastroenterological societies and associations to refine the practice guidelines and include iron deficiency as a potential morbidity associated with IBD in analogy to arthritis, uveitis or any other extra intestinal manifestations. There should a more unanimous agreement among different societies on the specific diagnostic cutoff values for C-reactive protein levels, serum ferritin, and transferrin saturation in order to differentiate iron deficiency anemia from anemia of chronic disease.

Keywords: Iron deficiency; anemia of chronic disease; inflammatory bowel disease; intravenous iron; iron deficiency anemia; oral iron.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anemia / diagnosis
  • Anemia / etiology
  • Anemia / therapy
  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / etiology*
  • Anemia, Iron-Deficiency / therapy
  • Disease Management
  • Drug Administration Routes
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / metabolism*
  • Iron / administration & dosage
  • Iron / adverse effects
  • Iron / therapeutic use
  • Practice Guidelines as Topic
  • Treatment Outcome

Substances

  • Iron