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 .
Oral and intravenous iron treatment in inflammatory bowel disease: Hematological response and quality of life improvement
Background : The aim was to evaluate the efficacy and tolerance of oral and intravenous iron treatment in anemic inflammatory bowel disease ( IBD ) patients , considering both hematological and quality ‐of‐life outcomes . Methods : We performed a prospect i ve multicenter study in IBD patients with iron deficiency anemia . Patients having hemoglobin > 10 g/dL were prescribed oral ferrous sulfate . If hemoglobin < 10 g/dL , intravenous ( sucrose ) iron was administered . Oral iron‐intolerant patients were changed to intravenous treatment .  Clinical ( Truelove/Harvey – Bradshaw ) , hematological ( response defined as hemoglobin normalization ) , and quality ‐of‐life ( shortened CCVEII‐9 question naire ) evaluations were performed at baseline and at 3 and 6 months . Results : 100 IBD patients ( 59 Crohn 's disease , 41 ulcerative colitis ) were included . Mean basal hemoglobin levels were 10.8 ± 1.3 g/dL ( range , 6.6–12.9 ) . Seventy‐eight patients received oral treatment and 22 intravenous iron .  Hemoglobin normalization was achieved in 86 % of patients : 89 % with oral , and 77 % with intravenous iron . An IBD activity increase was not demonstrated in any patient . Four patients ( 5.1 % ) showed oral iron intolerance leading to discontinuation of treatment . No adverse events were reported for intravenous iron  . Hemoglobin correlated with CCVEII‐9 ( P < 0.001 ) . The CCVEII‐9 score increased in patients who normalized hemoglobin levels in 3 months ( from 58 ± 9 to 73 ± 10 ) or 6 months ( 54 ± 9 , 68 ± 12 , and 74 ± 10 ) ( P < 0.001 ) . Conclusions : Oral iron treatment is effective and well tolerated in most IBD patients , and does not exacerbate the symptoms of the underlying IBD . Intravenous iron , on the other h and , is an effective and safe alternative treatment for iron deficiency anemia in more severely anemic or intolerant patients . Anemia correction with iron treatment is associated with a relevant improvement in the patients ' quality of life . ( Inflamm Bowel Dis 2009
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 .