Intravenous Iron in Inflammatory Bowel Disease

One of the key symptoms of inflammatory bowel diseases (IBD) is anemia. The reported prevalence of IBD-associated anemia varies between 6% and 74%. Although the therapy of the underlying disease has improved during the past decade, significant anemia continues to be a relevant burden. Iron deficiency and anemia of chronic disease are frequently combined in these patients. Oral iron therapy has been associated with flares in ulcerative colitis, similar to what has been observed in animal models of colitis. Parenteral iron supplementation has become the preferred route as the safety and efficacy of iron sucrose has been demonstrated in several trials. Open questions relate to the use of iron sucrose for prevention of anemia, the target hemoglobin levels, and the immunologic role of iron in the setting of chronic bowel inflammation.