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We read with great interest the article by Lee et al,1 who performed an open-label clinical trial to compare the effects of per os (PO) versus intravenous iron replacement therapy (IRT) for iron deficiency in patients with IBD. They concluded that IRT in patients with iron deficiency or anaemia induced significant shifts in bacterial community structure and metabolite landscape in faeces, and PO iron therapy affected the presence of specific molecular bacterial species. These are impressive findings that raise two important issues.
First, Lee et al 1 enrolled participants with Crohn’s disease (n=31), UC (n=22) and non-IBD control anaemic subjects (n=19) for IRT intervention 3 months PO iron sulfate or intravenous iron sucrose. PO participants …