Impact of iron deficiency anemia on quality of life in patients with ulcerative colitis

Abstract

Advances in the last two decades have resulted in better long-term remissions in patients with ulcerative colitis (UC), which is defined as an idiopathic, chronic inflammatory disorder of the colonic mucosa. This better remission has not transformed into a better quality of life. Almost one-third of these patients have mild to moderate anemia, which is one of the main factors leading to decreased quality of life; hence we aimed to determine the prevalence of iron deficiency anemia (IDA) in UC during remission and its impact on the quality of life in this subpopulation. In this prospective study, all consecutive patients of UC in remission for the last 3 months were evaluated for disease activity by Simple Clinical Colitis Activity Index (SCCAI), IDA by blood parameters and quality of life by Short Inflammatory Bowel Disease Questionnaire (SIBDQ). All patients with proven IDA were given oral iron supplements (Ferrous Ascorbate elemental iron 100 mg) for 3 months. Blood parameters, SCCAI, and SIBDQ scores were evaluated at the end of therapy to compare them before iron supplementation. Out of 125 patients of UC seen during the study period, 69 were in remission. IDA was seen in 34 patients (49.27%). Median pre-intervention and postintervention quality of life scores—SIBDQ (4.9 [4.2-5.8] vs 5.4 [5.0-6.1]) and blood parameters [hemoglobin 10.7 (9.8-11.4) g% vs 13.2 (12.8-13.7) g%]—showed significant improvement after iron supplementation. Prevalence of IDA in UC during remission is common (49.27%). Oral iron supplementation improves the quality of life and anemia significantly without increasing disease activity in UC under remission.