Anemic Ulcerative Colitis Patients Often Not Treated for Iron Deficiency

Anemic Ulcerative Colitis Patients Often Not Treated for Iron Deficiency

More than a third of anemic ulcerative colitis (UC) patients are not tested for iron deficiency, and nearly 25 percent of patients who are tested and diagnosed with iron deficiency anemia (IDA) are not treated with iron replacement therapy, researchers have found.

The study, “Factors Predicting Testing and Treatment of Iron Deficiency in a Nationwide Cohort of Anemic UC Patients,” was published in the journal Inflammatory Bowel Diseases.

Reportedly the first U.S. nationwide study to evaluate the prevalence of testing for iron deficiency in anemic UC patients, the aim was to determine how frequently IDA patients are treated with iron supplementation.

IDA is an often untreated complication of ulcerative colitis. According to the American Society of Hematology, iron deficiency is the most common cause of anemia. An iron deficiency might result from eating too few iron-rich foods like meat, eggs or green leafy vegetables, or because our bodies can’t absorb iron very well, which ulcerative colitis patients know first-hand.

The study’s primary objective was to evaluate whether anemic ulcerative colitis patients had been tested for iron deficiency and, if IDA was confirmed, if they were treated with iron replacement therapy.

“Our study emphasizes the need to educate gastroenterologists and general practitioners to diagnose and treat iron deficiency anemia at an early stage,” Nabeel Khan, MD, a researcher at the University of Pennsylvania Perelman School of Medicine, said in a press release.

The study enrolled 836 patients within the VA Database who were newly diagnosed with UC between October 2001 and October 2011.

Seventy percent of these patients (585) developed anemia over the course of a median of eight years of follow-up; 68.6 percent of these patients (401) had iron study evaluation; 62.6 percent of patients (251) were diagnosed with IDA; and, among them, only 76.1 percent (191) were treated with oral iron therapy. No patients received intravenous iron therapy.

An additional analysis showed having mild anemia or moderate anemia, and being from the Midwest and Southern regions of the U.S., were independent predictors of a lower likelihood of anemic patients being tested for iron deficiency.

“Almost half the patients with mild anemia were not tested for [iron deficiency],” Khan and his colleagues said. “Once tested, almost half the patients with mild [iron deficiency anemia] were not treated with iron replacement therapy. Testing for [iron deficiency] in patients with anemia and subsequent treatment with iron replacement therapy should be considered among the quality process indicators in IBD.”