Iron deficiency anemia in IBD: an overlooked comorbidity

Expert Rev Gastroenterol Hepatol. 2021 Mar 11. doi: 10.1080/17474124.2021.1900730.Online ahead of print.

Yash Shah 1, Dhruvan Patel 2, Nabeel Khan 3 4


Author information

  • 1Hackensack Meridian Health Ocean Medical Center, Brick Township, NJ, USA.
  • 2Mercy Fitzgerald Hospital, Darby, PA, USA.
  • 3Corporal Michael J Crescenz VA Medical Center, Philadelphia, PA, USA.
  • 4Perelman School of Medicine, University of Pennsylvania, PA, USA.


Introduction: Iron Deficiency Anemia (IDA) is a leading cause of anemia in Inflammatory Bowel disease (IBD). IDA affects quality of life (QoL) and lead to developmental and cognitive abnormalities. Diagnosis of IDA in IBD is complicated as biochemical tests available at present cannot help distinguish between IDA and anemia of chronic disease. Soluble transferrin receptor ferritin index has been gaining popularity as it can diagnose IDA in presence of chronic inflammation. ECCO guidelines recommend a Hb increase of >2 g/dL and a TfS of >30% within 4 weeks as adequate therapeutic response. IV iron is preferred over oral iron as it bypasses gastrointestinal tract, rapidly increases haemoglobin and is not associated with intestinal inflammation. Our aim in this review is to provide a pathway for physicians to help them diagnose and appropriately treat IDA in IBD.Areas covered: In this review article, we have discussed current diagnosis and treatment in detail and have proposed new directions on how future research can help manage IDA in IBD effectively.Expert Opinion: Understanding the pathogenesis of IDA in IBD will further lead to exploring new potential diagnostic tests and treatment regimens for effective management of IDA in IBD.

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