Iron deficiency anaemia (IDA) occurs in 2-5% of adult men and postmenopausal women in the developed world and is a common cause of referral to gastroenterologists. Gastrointestinal (GI) blood loss from colonic cancer or gastric cancer, and malabsorption in coeliac disease are the most important causes that need to be sought.
These guidelines are primarily intended for Western gastroenterologists and gastrointestinal (GI) surgeons, but are applicable for other doctors seeing patients with iron deficiency anaemia (IDA). They are not designed to cover patients with overt blood loss or those who present with GI symptoms. GI symptoms or patients at particular risk of GI disease should be investigated on their own merits.
https://gut.bmj.com/content/gutjnl/60/10/1309.full.pdf
Anaemia is the most common systemic complication and extraintestinal manifestation of inflammatory bowel disease [IBD]. In the majority of cases, IBD-associated anaemia is a unique example of the combination of chronic iron deficiency and anaemia of chronic disease [ACD]. Other more rare causes of anaemia in IBD include vitamin B12 and
folate deficiency, toxic effects of medications, and others. The impact of anaemia on the quality of life of IBD patients is substantial. It affects various aspects of quality of life such as physical, emotional, and cognitive functions, the ability to work, hospitalization, and healthcare costs. Anaemia in IBD is not just a laboratory marker; it is a complication of IBD that needs appropriate diagnostic and therapeutic approaches.
Despite the broad use of anti-inflammatory therapy, anaemia may recur fast after successful therapy. As anaemia is a serious medical condition that may become life threatening [if blood transfusions are not available or compatible], preventive measures should be considered. Prevention of anaemia and maintenance of iron and vitamin stores are therefore warranted.
https://academic.oup.com/ecco-jcc/article/9/3/211/361529
The approach to the patient with gastrointestinal bleeding (GIB) can be very complex. A multidisciplinary panel of physicians with expertise in Gastroenterology, Anesthesiology, and Transfusion Medicine worked together to provide the best knowledge and guide clinical practitioners in the real setting of health institutions, characterized by disparate availability of human and technical resources. The authors propose a global and personalized approach according to different clinical scenarios to improve the outcomes of patients with GIB, for whom the reduction of inappropriate transfusions is crucial. The goal of this document is to provide clear and objective guidance through interventional algorithms toward a goal-directed approach according to the clinical situation and supported by the latest available scientific data on GIB management in different settings.
http://www.spanestesiologia.pt/webstspa/wp-content/uploads/2020/10/interventional-algorithm-in-gastrointestinal-bleeding.pdf
Anemia is considered a public health issue and is often caused by iron deficiency. Iron-deficiency anemia (IDA) often originates from blood loss from lesions in the gastrointestinal tract in men and postmenopausal women, and its prevalence among patients with gastrointestinal bleeding has been estimated to be 61%. However, few guidelines regarding the appropriate investigation of patients with IDA due to gastrointestinal bleeding have been published.
These recommendations may serve as a starting point for clinicians to better diagnose and treat IDA in patients with gastrointestinal bleeding, which ultimately may improve health outcomes in these patients.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723662/pdf/WJG-26-7242.pdf
Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), both in pediatric and in adult patients. Iron deficiency is the main cause of anemia in patients with IBD. Anemia is a clinically relevant comorbidity,
with impact on patients’ quality of life and it should be timely diagnosed and adequately treated. Currently, an active
treatment approach is the recommended strategy, with evidence showing efficacy and safety of intravenous iron formulations. However, evidence in pediatric age remains scarce and no clinical recommendations exist for the diagnosis and treatment of this particular age group. The present document represents the first national consensus on the management of anemia in pediatric IBD and is therefore particularly relevant. The authors anticipate that the proposed recommendations will be useful in daily clinical practice for diagnosing and managing iron deficiency and iron-deficiency anemia in the pediatric population with IBD.
https://www.karger.com/Article/Pdf/505071
The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work. pré-operatórios
https://journals.lww.com/ejanaesthesiology/Fulltext/2017/06000/Management_of_severe_perioperative_bleeding__.3.aspx
AA presente Norma aborda o diagnóstico e tratamento das deficiências de ferro no adulto. Considera-se como adulto os maiores ou iguais a 18 anos.
A anemia por deficiência de ferro, constitui a deficiência mais prevalente no mundo segundo a OMS que define anemia se: 1) Hemoglobina <13g/dl no homem e <12g/dl na mulher.
A deficiência de ferro vai desde o estado de depleção de ferro sem anemia à anemia ferropénica.
https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0302013-de-31122013-pdf.aspx
Objective To develop a set of evidence-based recommendations for patient blood management (PBM) and for research.
Conclusions and Relevance The 2018 PBM International Consensus Conference defined the current status of the PBM evidence base for practice and research purposes and established 10 clinical recommendations and 12 research recommendations for preoperative anemia, RBC transfusion thresholds for adults, and implementation of PBM programs. The relative paucity of strong evidence to answer many of the PICO questions supports the need for additional research and an international consensus for accepted definitions and hemoglobin thresholds, as well as clinically meaningful end points for multicenter trials.
https://jamanetwork.com/journals/jama/article-abstract/2727453