Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee

Anaemia is a frequent consequence of many gastrointestinal (GI) diseases in children and it can even be the initial presenting symptom of underlying chronic GI disease. The definition of anaemia is age and gender-dependent and it can be classified based on pathophysiology, red cell morphology, and clinical presentation. Although nutritional deficiencies, including GI malabsorption of nutrients and GI bleeding, play a major role, other pathophysiologic mechanisms seen in chronic GI diseases, whether inflammatory (e.g., inflammatory bowel disease) or not (e.g., coeliac disease and dysmotility), are causing anaemia. Drugs, such as proton pump inhibitors, mesalamine, methotrexate and sulfasalazine, are also a potential cause of anaemia. Not uncommonly, due to a combination of factors, such as iron deficiency and a chronic inflammatory state, the underlying pathophysiology may be difficult to decipher and a broad diagnostic work-up is required. The goal of treatment is correction of anaemia by supplementation of iron and vitamins. The first therapeutic step is to treat the underlying cause of anaemia including bleeding control, restoration of intestinal integrity and reduction of inflammatory burden. The route of iron and vitamin supplementation is guided by the severity of anaemia.

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Publication Details

Journal
Journal of Pediatric Gastroenterology and Nutrition
Published
2025-01-09
DOI
https://doi.org/10.1002/jpn3.12454
Citations
5
Primary Topic
Iron Metabolism and Disorders
Type
article
Field-Weighted Citation Impact
8.85

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article

Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee

Amit Assa, Sara Sila, Marco Deganello Saccomani, Erasmo Miele et al.
5 citations
Journal of Pediatric Gastroenterology and Nutrition
Iron Metabolism and Disorders
8.85
article

Approach to anaemia in gastrointestinal disease: A position paper by the ESPGHAN Gastroenterology Committee

Amit Assa, Sara Sila, Marco Deganello Saccomani, Erasmo Miele, Zrinjka Mišak, Emmanuel Mas, Jernej Dolinšek, Osvaldo Borrelli, Christos Tzivinikos, Ilse Broekaert, Matjaž Homan, Mike Thomson, Javier Martín‐de‐Carpi
article en
5 citations

Abstract

Anaemia is a frequent consequence of many gastrointestinal (GI) diseases in children and it can even be the initial presenting symptom of underlying chronic GI disease. The definition of anaemia is age and gender-dependent and it can be classified based on pathophysiology, red cell morphology, and clinical presentation. Although nutritional deficiencies, including GI malabsorption of nutrients and GI bleeding, play a major role, other pathophysiologic mechanisms seen in chronic GI diseases, whether inflammatory (e.g., inflammatory bowel disease) or not (e.g., coeliac disease and dysmotility), are causing anaemia. Drugs, such as proton pump inhibitors, mesalamine, methotrexate and sulfasalazine, are also a potential cause of anaemia. Not uncommonly, due to a combination of factors, such as iron deficiency and a chronic inflammatory state, the underlying pathophysiology may be difficult to decipher and a broad diagnostic work-up is required. The goal of treatment is correction of anaemia by supplementation of iron and vitamins. The first therapeutic step is to treat the underlying cause of anaemia including bleeding control, restoration of intestinal integrity and reduction of inflammatory burden. The route of iron and vitamin supplementation is guided by the severity of anaemia.

Journal of Pediatric Gastroenterology and NutritionVol. 80(3)
University of Verona (IT), Hospital Sant Joan de Déu Barcelona (ES), Université Toulouse III - Paul Sabatier (FR), University of Ljubljana (SI), Inserm (FR), École Nationale Vétérinaire de Toulouse (FR), Université Fédérale de Toulouse Midi-Pyrénées (FR), University of Cologne (DE), Great Ormond Street Hospital (GB), Ljubljana University Medical Centre (SI), Shaare Zedek Medical Center (IL), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (FR), Mohammed Bin Rashid University of Medicine and Health Sciences (AE), Institut de Recherche en Santé Digestive (FR), University Clinical Centre Maribor (SI), Children's Hospital Zagreb (HR), Hôpital des Enfants (FR), Dubai Medical College (AE), University Hospital Cologne (DE), Sheffield Children's Hospital (GB), University College London (GB), University of Naples Federico II (IT)
Sanofi, Mead Johnson Nutrition, Danone, Norgine
Zero hunger
Openalex Percentile: Top 3%
Iron Metabolism and Disorders
8.85
DOIOpen Access PDFOpenAlex
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