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2018 ; 11
(ä): 1756284818769074
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Practical guidance for the management of iron deficiency in patients with
inflammatory bowel disease
#MMPMID29760784
Niepel D
; Klag T
; Malek NP
; Wehkamp J
Therap Adv Gastroenterol
2018[]; 11
(ä): 1756284818769074
PMID29760784
show ga
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.