Introduction The current prevalence of IBD in UK is said to be 400/100,000 (0.4%). Anaemia is a common problem in IBD, contributing to tiredness and lethargy, and has multifactorial causes. Current ECCO guidelines recommend that all patients with IBD should be assessed for iron deficiency anaemia (IDA) and that iron supplementation be given as indicated in their European Consensus Guidelines .
Objective To assess the prevalence of Iron deficiency anaemia (IDA) in our IBD cohort,. The frequency these patients presented with IDA was also reviewed, along with the appropriate provision of intravenous (IV) iron, where needed.
Method The Luton and Dunstable (L and D) University Hospital serves a catchment of 3 30 000 and has a database of 3014 IBD patients (0.9%). This is made up of 186 Proctitis, 1447 UC, 1037 Crohn’s, 71 Microscopic colitis, 273 Indeterminate colitis patients. A 7 year retrospective database was also created, documenting each occasion a patient to the hospital with blood tests confirming iron deficiency anaemia (IDA). For the purposes of this study we defined iron deficiency anaemia as a haemoglobin level of <13 g/L for men and <12 g/L for women, in the presence of a ferritin of <50 ng/ml. The two databases were compared and the number of presentations with IDA over that 7 year period was assessed, along with the demand for IV iron.
Results The prevalence of IBD is high in the local area (almost 1%). Over the 7 year review period, 633 (21%) of our local IBD patients were found to have IDA, with an median Hb level of 118 (130-47) g/L and ferritin count of 16.9 (49.8–2.4) ng/ml (median for men and women for Hb was 114 and 119 respectively, and for ferritin was 18.3 and 15.2 g/L, respectively). Of these, just 71 (11.3%) with a median Hb level of of 109 (130-35) g/L and ferritin count of 12.7 (40–1) ng/ml, received IV iron infusion. These 71 patients had presented 764 times (average 10.7 times) over 7 years with IDA that had not been appropriately corrected before they received an iron infusion.
Conclusion Iron deficiency anaemia was common (21%) in our local IBD cohort. Iron replacement therapy was mostly administered in the oral form. Current practice in our trust does not comply with ECCO guidelines. Just 11.3% were considered for IV iron therapy, despite these patients repeatedly presenting with IDA (on average 10.7 times over 7y), and ferritin counts below 30 ng/ml. Closer adherence to ECCO guidelines is needed, in order to improve the general well being of our patients and prevention of recurrent attendances.
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Disclosure of Interest None Declared
- Inflammatory bowel disease
- Iron therapy