Stein Jürgen, Connor Susan, Virgin Garth, Ong David Eng Hui, Pereyra Lisandro
Jürgen Stein, Interdisciplinary Crohn Colitis Centre Rhein-Main, Frankfurt am Main, Department of Gastroenterology and Clinical Nutrition, DGD Clinics Sachsenhausen, Frankfurt am Main, 60594 Frankfurt, Germany.
World J Gastroenterol. 2016 Sep 21;22(35):7908-25. doi: 10.3748/wjg.v22.i35.7908.
Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice.
缺铁性贫血(IDA)与多种非炎症性肠病的病理性胃肠道疾病有关,也与肝脏疾病有关。慢性出血、吸收不良和炎症等不同因素可能导致IDA。尽管贫血症状患者经常被转诊给胃肠病学家,但诊断方法、治疗选择以及随访措施并不规范且不尽人意。缺铁即使没有贫血,也会对身体和认知功能产生重大影响,并降低生活质量。因此,定期评估铁状态并了解铁状态受损的临床后果至关重要。虽然由于有效且耐受性良好的胃肠外铁制剂的出现,IDA的治疗选择范围正在增加,但目前缺乏对患有胃肠道疾病患者的IDA及其治疗的全面概述。此外,铁状态的定义和评估缺乏一致性,关于这一主题的专家指南也很少。本综述总结了目前关于IDA作为特定胃肠道和肝脏疾病常见合并症的观点,从而鼓励对贫血和缺铁采取更统一的治疗方法,同时为胃肠病学家在日常临床实践中治疗IDA的选择提供指导。