Managing iron deficiency and iron deficiency anemia in inflammatory bowel disease. The results of the "Gestiona hierro-EII" survey

Casellas Jordá F1, Vera Mendoza I2, Barreiro-de Acosta M3, Vázquez Morón JM4, López Román J5, Júdez Gutiérrez J6. Rev Esp Enferm Dig. 2018 Mar;110(3):172-178. doi: 10.17235/reed.2018.5354/2017.

Author information

1 Servicio de Digestivo, Hospital Universitari Vall d'Hebron, España.

2 Servicio de Digestivo, Hospital Universitario Puerta de Hierro.

3 Aparato digestivo, Hospital Clínico de Santiago, España.

4 Servicio de Digestivo, Hospital Juan Ramón Jiménez.

5 Fundación para la Formación e Investigación Sanitarias de la Región de Murcia.

6 Gestion del conocimiento, Fundacion SEPD, España.


INTRODUCTION: iron deficiency anemia is a common and very relevant manifestation of inflammatory bowel disease (IBD). Although clinical practice guidelines have been published and updated on this subject, the management in the daily practice of this complication is far from optimal.

OBJECTIVE: to determine the actual management, needs and limitations of anemia in IBD by means of a survey of gastroenterology specialists.

MATERIAL AND METHODS: a self-administered telematic survey was carried out between April and May 2017 and was sent to SEPD members. The survey included four sections: participant demographics, monitoring, treatment and limitations/needs.

RESULTS: a total of 122 evaluable surveys were received from all Spanish autonomous communities. Iron deficiency anemia is considered as a frequent manifestation of IBD and is monitored in all patients via the measurement of hemoglobin and ferritin. In the case of anemia, the survey respondents found it necessary to rule out the presence of IBD activity. However, only 14.8% prescribed intravenous iron when IBD was active. The required dose of intravenous iron is mainly calculated according to patient needs but only 33.1% of clinicians infused doses of 1 g or more.

CONCLUSIONS: the "Gestiona Hierro EII" survey on the management of anemia in IBD demonstrated a high quality of care, even though some aspects need to be improved. These included the prescription of intravenous iron for patients with disease activity, the use of high-dose intravenous iron and the implementation of algorithms into clinical practice.

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