I had a bit of a nightmare getting my iron infusion this time around, as I swapped GP surgeries and no one there seemed to be able to understand the term “Does not tolerate oral iron”! Anyway, after multiple phone calls, appointments, and repeat blood tests, then a final appointment to remind them that I can’t tolerate oral iron (doh), I finally got my infusion this week, a whole 3 months after they initially found it was low.

Anyway, I wanted to talk a little bit about iron deficiency anaemia in IBD; what it is and how it’s treated, as it’s a pretty common extraintestinal manifestation that many of us deal with.

Possible causes of iron deficiency anaemia

• Chronic blood loss
• Impaired iron absorption due to
  • tissue inflammation
  • surgery (resection)
  • treatments
• Poor nutrition due to dietary restrictions

Is it any wonder it’s something that people with IBD are prone to getting?

Common iron deficiency anaemia symptoms

• Extreme fatigue
• Weakness
• Pale skin
• Chest pain
• Palpitations
• Shortness of breath
• Headache
• Dizziness / Light-headedness

Diagnosing iron deficiency anaemia

Because some of the symptoms overlap with those you may already be experiencing with IBD, it can sometimes take a while to get a diagnosis. If you notice any of the common symptoms, it’s always worth getting checked out – it just takes a simple blood test! If you’re feeling particularly lethargic or weak, it’s worth having a full blood count plus your B12 and Vitamin D checked, because they’re also common deficiencies in people with IBD.

The first symptoms I tend to notice are breathlessness and sore muscles, but sore muscles don’t really get mentioned in symptom lists! I feel like I’ve overdone it at the gym and can struggle to even move around for a couple of days, after just nipping to the local shop!

Iron deficiency anaemia treatment options

Oral iron preparations are inexpensive and convenient, but they can cause side effects such as abdominal pain, constipation and diarrhoea. These may only be partly absorbed due to inflammation, and non-absorbed iron can be toxic and worsen IBD disease activity.

If you can get away with oral iron and it works for you then that’s probably the ideal route. I find it pretty annoying that I have to take time out of work to go for infusions, plus the travel expense and time on top of that! That said, iron infusions are often required for people with Crohn’s disease and ulcerative colitis.

Having spoken to people that have iron infusions, I’ve noticed that there seems to be quite a big difference in terms of the brand of iron, how long the infusion takes, AND how long you’re kept for observation after the infusion. It’s definitely worth checking how long you will be there as you may want to take a book, and if you’re a grazer like me, some snacks!

I’ve had quite a few infusions now and I usually tolerate them well, but the last one made me feel very weak and sore the day after. Plus, I woke up with a throbbing headache which took most of the day to shift! Some people say that the weakness lasts days for them, and stomach pain, constipation and diarrhoea may also be experienced. So, you may want to allow yourself a little recuperation time afterwards, if possible, too!

With any luck, you should start to feel the benefits and your symptoms fading within a couple of weeks, but for some, it may take a little longer. I always request a follow-up blood test after three months, just to make sure it was all absorbed and has topped me up sufficiently!

If you’re due an infusion any time soon, good luck! If you’ve recently had one, or you regularly do, I’d be interested to hear about your experiences!