IRON DEFICIENCY ANEMIA IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE PRESENTING TO A TERTIARY CARE HOSPITAL

Abstract

Objective: To determine the frequency of iron deficiency anemia (IDA) in patients with inflammatory bowel disease (IBD) presenting to a tertiary care hospital in Faisalabad, Pakistan.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Department of Medicine, Allied-II (DHQ) Hospital, Faisalabad, from November 2025 to March  2026.

Methodology: A total of 194 confirmed IBD patients aged 18–60 years were enrolled through non-probability consecutive sampling. IDA was defined using WHO sex-specific haemoglobin thresholds (<13 g/dL for males, <12 g/dL for females) combined with ECCO-recommended serum ferritin <30 ng/mL. Chi-square tests with crude odds ratios (OR) and 95% confidence intervals (CI) were computed for univariate analysis. Binary logistic regression was performed to identify independent predictors of IDA.

Results: Of 194 patients, 88 (45.4%) had IDA. The mean age was 37.3 ± 9.2 years with 110 (56.7%) males and 84 (43.3%) females. Ulcerative colitis was the predominant IBD type (112; 57.7%). On univariate analysis, female sex was significantly associated with IDA (54.8% vs 38.2%; OR=1.96, 95% CI: 1.10–3.49; p=0.022). On multivariate logistic regression, female sex remained the only independent predictor (adjusted OR=2.04, 95% CI: 1.12–3.69; p=0.019). Polypharmacy showed a borderline association (aOR=1.83, 95% CI: 0.97–3.44; p=0.062).

Conclusion: IDA is a frequent complication in IBD patients at this tertiary care centre, affecting nearly half the cohort. Female sex was the only independent predictor. Routine iron status screening using sex-specific haemoglobin thresholds and inflammation-adjusted ferritin criteria is recommended for all IBD patients.