Complications and Extraintestinal Manifestations

Anemia is a deficiency of red blood cells or hemoglobin in the blood. One major symptom of anemia is fatigue. Other symptoms include a pale appearance and reduced ability to exercise.

About 14% to 19% of people with IBD have anemia, and 20% to 54% are low in iron.

Most cases of anemia in IBD are due to iron deficiency. Inflammation, intestinal blood loss, reduced iron absorption, and altered iron metabolism can contribute to anemia. Another cause is low vitamin B12.

Your health care provider can check for anemia using blood tests that measure hemoglobin and serum ferritin (a measure of your iron stores). Sometimes other tests are needed. In patients with IBD, screening for anemia is recommended every three months in those with active disease, and every six to 12 months for those in remission.

The treatment of anemia depends on its cause. If the anemia is due to low iron, supplements can help. Foods high in iron include spinach, liver, red meat, and legumes.

Some people require intravenous iron therapy.

If you are experiencing inflammation, you might need a change in your IBD medications.

If you have developed anemia from blood loss, you may need to supplement with iron, folic acid, or vitamin B12, depending on what your doctor says. In serious cases of blood loss, a blood transfusion might be required.