| Popis: |
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. |
