title: Oral iron therapy in inflammatory bowel disease: usage, tolerance, and efficacy.
abstract: BACKGROUND
  Iron deficiency is common in inflammatory bowel disease (IBD). Anecdotal evidence suggests that oral iron is poorly tolerated and may exacerbate disease activity in patients with IBD. AIM The aim of this study was to retrospectively compare usage, tolerance, and efficacy of oral iron therapy in patients with IBD and noninflammatory causes of iron deficiency.
  
  
  METHODS
  Case records of 277 patients with IBD and 24 non-IBD iron-deficient control patients covering a 4-year period were retrospectively analyzed.
  
  
  RESULTS
  Fifty-three of 277 (19%) of the patients with IBD studied had received oral iron. In only 40% of the patients who had IBD and 63% of the patients who did not (p = not significant) was iron deficiency formally confirmed before treatment. Intolerance to iron was reported in only 25% of the patients who had IBD and 17% of the patients who did not (p = not significant). In only two of eight adequately monitored iron-intolerant patients with IBD was iron therapy associated with an increase in inflammatory markers. When formally checked, iron repletion was successfully achieved as frequently in patients who had IBD (59%) as in patients who did not (45%).
  
  
  CONCLUSIONS
  Iron therapy is often used without a formal diagnosis of iron deficiency having been made, at least in part because of the difficulty in making this diagnosis using ferritin, an acute-phase protein. Patients with IBD are no more intolerant of oral iron than other patients and have similar rates of repletion.
authors.affiliation: Department of Adult and Pediatric Gastroenterology, Barts and the London, Queen Mary School of Medicine and Dentistry, London, United Kingdom.
authors.forename: Anupama D
authors.initials: AD
authors.lastname: de Silva
authors.forename: Maria
authors.initials: M
authors.lastname: Mylonaki
authors.forename: David S
authors.initials: DS
authors.lastname: Rampton
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D007501:Iron / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D005293:Ferritins; D007501:Iron