Anemia commonly complicates inflammatory bowel disease (IBD).
In patients with chronic renal failure, the treatment of anemia with iron and erythropoietin improves both quality of life, and cognitive function.
The same drugs are effective in treating severe anemia in inflammatory bowel disease, but there is no evidence to direct the treatment of mild anemia.
Concern exists that the use of iron may exacerbate inflammation in patients with inflammatory bowel disease.
Dr Christopher Wells and colleagues examined the association between changes in hemoglobin in IBD patients.
| Changes in hemoglobin accounted for 18% of the variance of change in the Short Form-36|
|Inflammatory Bowel Diseases|
It changes in quality of life and cognitive function independent of change in disease activity.
Subsidiary aims were to assess whether the use of iron was associated with worsening disease activity.
The team included 50 patients with IBD, of which 29 had Crohn's disease, and 21 had ulcerative colitis.
Iron replacement was given to 21 patients with low hemoglobin.
Measures of quality of life, cognitive function , disease activity, and hemoglobin were recorded at baseline and at 6 months.
The researchers found that the iron-treated group had lower hemoglobin and higher disease activity scores vs the non-iron-treated group at baseline.
A hierarchical regression model was used for further analysis.
Changes in disease activity accounted for 13%, and changes in hemoglobin accounted for 18% of the variance of change in the Short Form-36.
The team noted that changes in disease activity and haemoglobin accounted for and 12% and 17%, respectively, in the IBD Questionnaire.
In this pilot study, although no associations were identified between changes in hemoglobin or disease activity, and cognitive function.
The team noted that increases in hemoglobin improved quality of life scores in IBD patients independent of changes in disease activity.
The researchers found no similar effect with cognitive function, but again, the sample size was small.
There was also no evidence that iron therapy causes worsening of disease activity.
Dr Wells' team concluded, “Treatment of inflammatory bowel disease-associated anemia with iron may lead to improvement in patients' quality of life.”