Anaemia in inflammatory bowel disease – aetiopathogenesis, diagnosis and management

Anaemia is the most frequent systemic complication in patients with inflammatory bowel disease (IBD), having a great impact on clinical status, quality of life and more frequent hospitalizations. Aetiopathogenesis of IBD-asso­cia­ted anaemia is complex. However, the most common causes are iron deficiency and anaemia of chronic disease. Although in many cases anaemia parallels the clinical activity of the disease, many patients in remission have iron, vitamin B12 and/or folic acid deficiency. Treatment of iron deficiency anaemia depends on the disease activity and severity of symptoms. Oral iron preparations are efficacious but poorly tolerated, whereas well-tolerated parenteral iron therapy is advantageous and restocks iron stores quicker. In some cases erythropoietin is needed to achieve normal haemoglobin levels. Appropriate knowledge of anaemia and clinical guidelines are therefore necessary to apply relevant attention and specific care in IBD patients.