Management of iron-deficiency anemia following acute gastrointestinal hemorrhage: A narrative analysis and review

Lanas, Angel (Universidad de Zaragoza) ; Andrews, Jane M ; Lau, James ; Toruner, Murat ; Bromley, Susan E ; Gralnek, Ian M

Resumen: Many patients experiencing acute gastrointestinal bleeding (GIB) require iron supplemen-tation to treat subsequent iron deficiency (ID) or iron-deficiency anemia (IDA). Guidelinesregarding management of these patients are lacking. We aimed to identify areas of unmetneed in patients with ID/IDA following acute GIB in terms of patient management andphysician guidance. We formed an international working group of gastroenterologists toconduct a narrative review based on PubMed and EMBASE database searches (fromJanuary 2000 to February 2021), integrated with observations from our own clinical expe-rience. Published data on this subject are limited and disparate, and those relating topost-discharge outcomes, such as persistent anemia and re-hospitalization, are particularlylacking. Often, there is no post-discharge follow-up of these patients by a gastroenterolo-gist. Acute GIB-related ID/IDA, however, is a prevalent condition both at the time of hos-pital admission and at hospital discharge and is likely underdiagnosed and undertreated.Despite limited data, there appears to be notable variation in the prescribing of intravenous(IV)/oral iron regimens. There is also some evidence suggesting that, compared with oraliron, IV iron may restore iron levels faster following acute GIB, have a better tolerabilityprofile, and be more beneficial in terms of quality of life. Gaps in patient care exist inthe management of acute GIB-related ID/IDA, yet further data from largepopulation-based studies are needed to confirm this. We advocate the formulation ofevidence-based guidance on the use of iron therapies in these patients, aiding a more stan-dardized best-practice approach to patient care.

Idioma: Inglés

DOI: 10.1111/jgh.16033

Año: 2023

Publicado en: Journal of Gastroenterology and Hepatology (Australia) 38, 1 (2023), 23-33
ISSN: 0815-9319

Factor impacto JCR: 3.7 (2023)

Categ. JCR: GASTROENTEROLOGY & HEPATOLOGY rank: 40 / 143 = 0.28 (2023) - Q2 - T1

Factor impacto CITESCORE: 7.9 - Hepatology (Q2) - Gastroenterology (Q1)

Factor impacto SCIMAGO: 1.179 - Gastroenterology (Q1) - Hepatology (Q2)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)