Rai Seema
Department of Pediatrics, Guru Gobind Singh Medical College & Hospital, Faridkot 151203, Punjab, India.
World J Clin Pediatr. 2024 Sep 9;13(3):93697. doi: 10.5409/wjcp.v13.i3.93697.
Inflammatory bowel disease (IBD) is a relapsing chronic inflammatory disorder of the small and large gut with rising incidence and prevalence worldwide. Iron deficiency anemia is one of the most common extraintestinal manifestations of IBD, which correlates with the disease activity and tendency to relapse even after successful management. Anemia affects various aspects of quality of life, such as physical, cognitive, emotional, and workability, as well as healthcare costs. The anemia in IBD can be due to iron deficiency (ID) or chronic disease. The relative frequency of ID in IBD is 60%, according to some studies, and only 14% receive treatment. The evaluation of ID is also tricky as ferritin, being an inflammatory marker, also rises in chronic inflammatory diseases like IBD. The review of anemia in IBD patients involves other investigations like transferrin saturation and exploration of other nutritional deficiencies to curb the marker asthenia with which these patients often present. It underscores the importance of timely investigation and treatment to prevent long-term sequelae. We can start oral iron therapy in certain circumstances. Still, as inflammation of the gut hampers iron absorption, an alternative route to bypass the inflamed gut is usually recommended to avoid the requirement for blood transfusions.
炎症性肠病（IBD）是一种发生于小肠和大肠的复发性慢性炎症性疾病，在全球范围内其发病率和患病率都在上升。缺铁性贫血是IBD最常见的肠外表现之一，它与疾病活动度相关，即使在成功治疗后仍有复发倾向。贫血会影响生活质量的各个方面，如身体、认知、情绪和工作能力，还会增加医疗费用。IBD中的贫血可能是由于缺铁（ID）或慢性疾病所致。根据一些研究，IBD中ID的相对发生率为60%，但只有14%的患者接受治疗。由于铁蛋白作为一种炎症标志物，在IBD等慢性炎症性疾病中也会升高，因此对ID的评估也很棘手。对IBD患者贫血的评估还涉及其他检查，如转铁蛋白饱和度以及对其他营养缺乏情况的排查，以控制这些患者常出现的虚弱症状。这凸显了及时进行检查和治疗以预防长期后遗症的重要性。在某些情况下我们可以开始口服铁剂治疗。然而，由于肠道炎症会妨碍铁的吸收，通常建议采用替代途径绕过发炎的肠道，以避免输血的需求。
