Frequency of Iron Deficiency Anemia Among Patient with Chronic Use of Proton Pump Inhibitor

Background: Proton pump inhibitors (PPIs) are widely used for managing acid-related disorders. However, prolonged use may impair iron absorption, potentially leading to iron deficiency anemia (IDA). This study aimed to determine the prevalence of IDA among chronic PPI users and assess its association with demographic and clinical factors. Methods: A cross-sectional study was conducted on 291 patients using PPIs for 6 months, at Department of Medicine at Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2024 to May 2025. Data on age, gender, place of residence, diabetes, hypertension, family history of anemia, smoking status, and family monthly income were collected. Hemoglobin, ferritin, and total iron-binding capacity (TIBC) levels were measured to diagnose IDA. Associations between IDA and independent variables were analyzed using chi-square tests, with a significance level of p ≤ 0.05. Results: The prevalence of IDA was 21.3%. Trends indicated that IDA was slightly more common in males (53.2%) than females (46.8%) and was equally distributed among rural and urban participants (50.0% each). IDA occurred at similar rates in diabetic (50.0%) and non-diabetic participants. Non-hypertensive individuals (58.1%) had a higher prevalence of IDA compared to hypertensive individuals (41.9%). Participants without a family history of anemia (54.8%) had more IDA cases than those with a positive history (45.2%). Non-smokers accounted for the majority of IDA cases (56.5%), while ex-smokers and current smokers represented 25.8% and 17.7%, respectively. IDA was more common among participants earning ≤60,000 PKR (56.5%) compared to those with higher incomes (43.5%). Conclusion: This study found a 21.3% prevalence of iron deficiency anemia among patients on long-term PPI therapy. Although no significant associations were identified, trends suggest that gender, income, and lifestyle factors may influence IDA.