One of the most frequent extraintestinal symptoms of inflammatory bowel disease is anemia (IBD). It might be asymptomatic or cause nonspecific symptoms including irritability, headaches, tiredness, dizziness, and anorexia. The cause of anemia in IBD patients is frequently complex. Iron deficiency, anemia of inflammation and chronic illness, vitamin deficiencies, hemolysis, or drug-induced myelosuppression are all possible causes. Anemia and iron deficiency in these individuals may be underestimated because of their gradual development, a lack of standardized screening methods, and potentially an underestimation that anemia therapy is also necessary while treating IBD. Because of intolerance, practitioners may be hesitant to employ oral preparations, but intravenous medicines are underused due to concern of adverse effects, availability, and expense. In recent years, several studies have shown the safety and comparative effectiveness of different intravenous formulations. This article discusses the management of anemia in children with IBD, including diagnosis, etiopathogenesis, patient evaluation, a protocol for screening and monitoring patients for early detection and response to therapy, treatment, including parenteral iron therapy, and newer approaches in chronic disease anemia management.
After an extensive review of the current literature, a group of pediatric gastroenterologists serving on the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) IBD committee, in collaboration with a pediatric hematologist, pharmacist, and a registered dietician who specializes in pediatric IBD, compiled this report. The goal of this study is to increase awareness of anemia under-diagnosis in children with IBD and to give recommendations for screening, testing, and therapy in this population.