Diagnosis and Treatment of Anemia in Inflammatory Bowel Disease

Anemia in patients with inflammatory bowel disease (IBD) is caused in more than 80% of cases by iron and/or vitamin deficiency. In single cases hemolysis or myelosuppression occurs. The exact mechanisms are unknown. In the remaining patients (10-20%), substitution treatment does not improve anemia. Laboratory tests are often obscured by changes induced by the immunologic activity of the inflammatory disorder. Recent studies have demonstrated that the proinflammatory cytokines produced in IBD can suppress erythropoiesis by the inhibition of erythropoietin secretion and action. In therapeutic trials, it has been shown that coadministration of recombinant erythropoietin can substantially improve therapy in those with refractory anemia in IBD.