However , in patients with IBD flares and inadequate responses to or side effects with oral preparations , intravenous iron supplementation is the therapy of choice .
Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD , and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics .
Based on the data presented , oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency  anemia unless such patients are intolerant or have an inadequate response , whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron
Abstract Anemia is the most frequent complication of inflammatory bowel disease ( IBD ) , but anemia , mostly due to iron deficiency , has long been neglected in these patients .
The aim was to briefly present the pathophysiology , followed by a balanced overview of the different forms of iron replacement available , and subsequently , to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD .
High burden of iron deficiency and different types of anemia in inflammatory bowel disease outpatients in Scandinavia: A longitudinal 2-year follow-up study
Abstract Objective . The prevalence of anemia in inflammatory bowel disease ( IBD ) has been broadly described . The recurrence , type and burden of anemia remain unenlightened . The primary objective was to describe this . The secondary objective was to evaluate the implementation of European guidelines . Material s and methods . This longitudinal follow-up study included 300 IBD out patients from six centers in Sc and inavia . Patients were enrolled in a research cohort , in which each center included 5 % of their IBD cohort . The study was prospect ively planned , while data were retrospectively collected . The burden of anemia was calculated as number of months with anemia . A Markov model was used to calculate the probabilities of transitioning between stages . The European guidelines were used as the st and ard for anemia management . Results . Anemia affected > 50 % of IBD out patients during the 2-year observation period . Totally , 20 % of the total observation time was spent in anemia . Over the 7200 months of observation , anemia was found in 1410 months . The most frequent type was combined anemia ( 63 % ) . Combined anemia covers both anemia of chronic disease ( ACD ) and iron-deficiency anemia ( IDA ) . Pure ACD was present in 21 % of burden time , while pure IDA was present in 16 % of burden time . The European guidelines have mainly been implemented . Conclusion . Anemia affected a majority of the IBD out patients . One in five months , the patients were anemic . Anemia related to inflammation dominated the different types of anemia . Pure IDA was found in for 16 % . These findings , despite a fair implementation of guidelines
However , in patients with IBD flares and inadequate responses to or side effects with oral preparations , intravenous iron supplementation is the therapy of choice .
Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD , and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics .
Based on the data presented , oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency  anemia unless such patients are intolerant or have an inadequate response , whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron
Abstract Anemia is the most frequent complication of inflammatory bowel disease ( IBD ) , but anemia , mostly due to iron deficiency , has long been neglected in these patients .
The aim was to briefly present the pathophysiology , followed by a balanced overview of the different forms of iron replacement available , and subsequently , to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD .