Iron deficiency anaemia is one of the most common disorders in the world. Also, one third of inflammatory bowel disease (IBD) patients suffer from recurrent anaemia. Anaemia has significant impact on the quality of life of affected patients. Chronic fatigue, a frequent IBD symptom itself, is commonly caused by anaemia and may debilitate patients as much as abdominal pain or diarrhoea. Common therapeutic targets are the mechanisms behind anaemia of chronic disease and iron deficiency. It is our experience that virtually all patients with IBD associated anaemia can be successfully treated with a combination of iron sucrose and erythropoietin, which then may positively affect the misled immune response in IBD.
Iron deficiency anaemia is one of the most common disorders in the world. The World Health Organization estimates that more than 30% of the population have iron deficiency anaemia yet it remains an under managed feature of many gastroenterological conditions. Also, one third of inflammatory bowel disease (IBD) patients suffer from recurrent anaemia. Anaemia has significant impact on the quality of life of affected patients. Chronic fatigue, a frequent IBD symptom itself, is commonly caused by anaemia and may debilitate patients as much as abdominal pain or diarrhoea.
Both iron deficiency and anaemia of chronic disease contribute most to the development of anaemia in IBD. Cobalamin or folate deficiency and various other causes of anaemia such as haemolysis occur infrequently. Common therapeutic targets are the mechanisms behind anaemia of chronic disease and iron deficiency. Oral iron treatment is limited by poor absorption, intolerance, and induction of oxidative stress at the site of bowel inflammation.
Intravenous iron sucrose has a good safety profile and a 65–75% response rate within 4–8 weeks, which is paralleled by improvement in the quality of life. Combination therapy with erythropoietin (Epo) leads to a faster and larger haemoglobin increase. It is our experience that virtually all patients with IBD associated anaemia can be successfully treated with a combination of iron sucrose and Epo, which then may positively affect the misled immune response in IBD.
IRON LOSS IN INFLAMMATORY BOWEL DISEASE
Iron deficiency anaemia (IDA) can be considered a gastroenterological condition. The leading causes of iron deficiency (ID) in the developed world are menstruation and blood loss associated with gastrointestinal disease. In the latter case, blood loss in the stomach or intestine cannot be matched by duodenal iron absorption, creating a negative iron balance. This imbalance is often seen in IBD, leading to anaemia. While our understanding of IBD has grown over the past decades, the prevalence of IBD associated anaemia has changed only little: one third of IBD patients still have haemoglobin levels below 12 g/dl.
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