Introduction Iron deficiency is the commonest micronutrient deficiency in IBD and causes impaired quality of life. 35% of patients have been reported to be iron deficient and 65% require iron replacement over the course of their disease. We analysed the diagnosis and treatment of iron deficiency in our local IBD cohort and compared this to BSG guidelines. They state that all IBD patients should have an annual full blood count and if anaemic (Hb <12 g/dl for women, Hb <13 for men) iron studies should be undertaken. If disease is inactive and ferritin <30 or there is active disease and ferritin <100, the patient should be on iron. This should be the recommended type of iron; IV iron in severe anaemia (haemoglobin <10) or severe intestinal disease activity, concomitant therapy with an erythropoietic agent, or patient preference. Hb should be rechecked after 4 weeks and if it does not rise by 2g/dl or normalise, IV iron should be started. If Hb <10 and there is no response to IV iron therapy within 4 weeks EPO should be given.
Methods A prospective study was undertaken in the Royal Berkshire NHS Foundation Trust of patients attending IBD clinics in December 2012. 100 patients attending clinic consecutively were recruited.
Conclusion Our study demonstrated good compliance with national guidance in screening for anaemia annually in IBD patients. Appropriate iron preparations were given in all patients. Only 81% patients commenced on iron had Hb re-checked after 4 weeks. Our study showed similar prevalence of iron deficiency in IBD patients to other studies but better detection and treatment (3).
We have a full-time IBD Specialist nurse who monitors patients’ tolerance of iron supplements. Patients are advised to telephone if they have side effects of medications and are not able to tolerate them. The presence of a nurse may improve bloods monitoring and iron prescription but may not be a service that can be provided nationally. Our IBD clinics are run by consultants only, which may also facilitate adherence to guidelines.
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Befrits R, et al. Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases. Inflamm Bowel Dis 2007:13:1545–53
Obermeier F et al. High prevalence but insufficient treatment of iron-deficiency anemia in patients with inflammatory bowel disease: results of a population-based cohort. Gastroenterol Res Pract. 2012:2012:595970
Disclosure of Interest None Declared.
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