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 .
Diagnostic accuracy of serum hepcidin for iron deficiency in critically ill patients with anemia
Purpose Inflammation-induced anemia is frequent among critically ill patients and can be aggravated by true iron deficiency ( ID ) result ing from blood losses . The serum hepcidin level controls the availability of iron for erythropoiesis , and its determination offers new perspectives for the diagnosis of ID in the presence of inflammation . We conducted a prospect i ve observational study to determine the cutoff value and diagnostic accuracy of hepcidin levels for detecting ID in critically ill anemic patients . Methods Patients suffering from anemia ( hemoglobin < 100 g/l ) and expected to stay for more than 7 days in intensive care had weekly determinations of hematological and iron parameters , including hepcidin levels ( ELISA test ) . The  iron status  for each set of measures was determined by the consensus of three experts , blinded to hepcidin values . Results Of 51 patients ( 36 male/15 female ) , 5 had ID at inclusion , while 8 developed ID during their stay . A total of 128 iron profiles were analyzed . Median hepcidin levels were 80.5 ( 0.05–548.3 ) and 526.6 ( 246.7–891.4 ) µg/l for ID and non-ID profiles , respectively . The onset of ID during the ICU stay led to a progressive decline in hepcidin levels , whereas a persistent inflammatory profile remained associated with high hepcidin concentrations . The optimal threshold for serum hepcidin for ID diagnosis was assessed by building 100 ROC curves using a resampling method and found at 129.5 µg/l [ 95 % CI = ( 115.5–143.4 ) ] . Conclusions Hepcidin levels may be suppressed by ID even in case of inflammation . Serum hepcidin of 129.5 µg/l was the most accurate threshold for ID diagnosis in critically ill patients with anemia
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 .