Jimenez Kristine, Kulnigg-Dabsch Stefanie, Gasche Christoph
Dr Jimenez is a fellow in gastroenterology, Dr Kulnigg-Dabsch is a specialist in internal medicine, and Dr Gasche is a specialist in internal medicine, gastroenterology, and hepatology and is an associate professor at the Medical University of Vienna in Vienna, Austria. Dr Gasche is also the founder and head of Loha for Life, Centre of Excellence for Iron Deficiency in Vienna, Austria.
Gastroenterol Hepatol (N Y). 2015 Apr;11(4):241-50.
Anemia affects one-fourth of the world's population, and iron deficiency is the predominant cause. Anemia is associated with chronic fatigue, impaired cognitive function, and diminished well-being. Patients with iron deficiency anemia of unknown etiology are frequently referred to a gastroenterologist because in the majority of cases the condition has a gastrointestinal origin. Proper management improves quality of life, alleviates the symptoms of iron deficiency, and reduces the need for blood transfusions. Treatment options include oral and intravenous iron therapy; however, the efficacy of oral iron is limited in certain gastrointestinal conditions, such as inflammatory bowel disease, celiac disease, and autoimmune gastritis. This article provides a critical summary of the diagnosis and treatment of iron deficiency anemia. In addition, it includes a management algorithm that can help the clinician determine which patients are in need of further gastrointestinal evaluation. This facilitates the identification and treatment of the underlying condition and avoids the unnecessary use of invasive methods and their associated risks.
贫血影响着全球四分之一的人口,缺铁是主要原因。贫血与慢性疲劳、认知功能受损和幸福感下降有关。病因不明的缺铁性贫血患者经常被转诊至胃肠病学家处,因为在大多数情况下,该病起源于胃肠道。恰当的管理可改善生活质量,缓解缺铁症状,并减少输血需求。治疗选择包括口服和静脉铁剂治疗;然而,在某些胃肠道疾病,如炎症性肠病、乳糜泻和自身免疫性胃炎中,口服铁剂的疗效有限。本文对缺铁性贫血的诊断和治疗进行了批判性总结。此外,还包括一个管理算法,可帮助临床医生确定哪些患者需要进一步的胃肠道评估。这有助于识别和治疗潜在疾病,避免不必要地使用侵入性方法及其相关风险。