Date Published: 
Wednesday, 22 May, 2013

How does iron deficiency affect clinical outcome in patients with gastrointestinal disorders?

Iron deficiency is associated with a range of symptoms that are not only detrimental to quality of life, but may also have a negative impact on clinical outcomes in gastrointestinal disease1. In severe cases, iron deficiency may result in patients taking increased time away from work, with a need for more frequent hospitalisation1.

Clinical symptoms

Iron deficiency can be associated with symptoms of fatigue and a reduction in cognitive function as well as hair loss, paraesthesia of the hands and feet and, and restless leg syndrome2. When iron deficiency progresses to iron deficiency anaemia, additional symptoms can include a reduction in physical performance, headache, dizziness and tachycardia and dyspnoea2.

In patients with Crohn’s disease and iron deficiency anaemia, correction of iron deficiency with IV iron resulted in significant improvements in quality of life and associated scores on the Crohn’s Disease Activity Index measure of symptoms3.

H.pylori infection

Iron deficiency may have a particularly important and specific role in the pathogenesis of gastric malignancies due to H. pylori infection. Iron depletion accelerates the development of H. pylori–induced premalignant and malignant lesions in vivo4. In patients with H. pylori infection, lower levels of iron (ferritin) are associated with more virulent H. pylori activity and more advanced gastric lesions (see figures below)4.

Figure 2. Lower iron stores correlate with greater H. pylori virulence as measured by gastric epithelial cell inflammatory response to infection4












Copyright permission obtained from Noto et el, 2013.

Figure 3. Lower iron stores correlate with more advanced lesions in H. pylori infection4














Copyright permission obtained from Noto et al, 2013.