Efficacy and tolerability of oral iron therapy in inflammatory bowel disease: a prospective, comparative trial

Abstract

SUMMARYBackground: In patients with inflammatory bowel disease, oral iron is anecdotally reported to be less effective and less well tolerated than in those without inflammatory bowel disease, and to increase disease activity. Aim: To study prospectively the effects of oral iron in patients with and without inflammatory bowel disease. Methods: Patients with ulcerative colitis, Crohn's disease and non-inflammatory bowel disease controls, all with iron deficiency anaemia, were assessed with symptom diaries, a quality of life questionnaire (Inflammatory Bowel Disease Questionnaire; inflammatory bowel disease patients only) and blood tests to measure iron repletion, disease activity and antioxidant capacity before and after starting 4 weeks of oral iron. In patients with ulcerative colitis, sigmoidoscopic scoring and rectal biopsies for reactive oxygen metabolite production were performed before and after iron therapy.

Serum Hepcidin and Iron Absorption in Paediatric Inflammatory Bowel Disease

“…Iron mucosal harm has been described in IBD. 28 Studies in animal models of colitis indicate that luminal iron may exacerbate disease activity. 29,30 In a more recent study, iron supplementation affected microbiota and increased faecal calprotectin.…”

Portuguese Consensus on the Diagnosis, Prevention and Treatment of Anaemia in Inflammatory Bowel Disease

“…The mainstay of treatment for iron deficiency depends on the administration of iron being available in various formulations for intravenous and oral supplementation use. The use of oral iron is associated with gastrointestinal side effects that limit effectiveness and tolerance, however, in patients with disease remission it may have less gastrointestinal sideeffects, 74 but those may be confused with complains of disease activity. 6 The use of intravenous iron is the most effective way to prevent iron deficiency associated with IBD.…”

Algorithmus zur Diagnose von Eisenmangelanämie

“…B. Antazida, Tetrazykline, Penicillamin, Chinolone, Cholestryramin, Bisphosphonate) sollten vermieden werden. Nicht-resorbiertes luminales Eisen könnte mukosale Schäden verursachen [88,89], intestinale Entzündung begünstigen und die Darmflora verändern [87].…”