Gastrointestinal tract (GIT) organs are the most important in the regulation of hematopoiesis and iron metabolism. Through the intestines, a constant controlled supply of most substances ensuring the production of erythrocytes is provided. Therefore, a number of chronic diseases of the digestive system are accompanied by the development of anemia of varying severity.
The underlying reason for the development of IDA in diseases of the gastrointestinal tract is chronic blood loss. Single abundant or repeated ones, even insignificant and latent blood loss leads to massive loss of iron, depletion of its reserves in the body and development subclinical state of iron deficiency at the beginning, and then to chronic posthemorrhagic iron deficiency anemia. Blood loss from the alimentary canal could occur in various diseases: periodontopathies, erosive and hemorrhagic gastritis, gastroesophageal reflux disease, gastric ulcer and duodenal ulcer, hernia of the esophageal opening of the diaphragm, liver cirrhosis, complicated by intestinal varicose veins of the esophagus and stomach ulcerative colitis, Crohn's disease, diverticulosis and intestinal polyposis, hemorrhoids, helminthic invasions.
The second most important reason for the development of IDA is a violation of the iron absorption in the duodenum and the proximal jejunum processes. Various diseases of the small intestine, accompanied by malabsorption syndrome (enteritis, amyloidosis, celiac disease, idiopathic steatorrhea), as well as gastrointestinal surgical procedures (conditions after total gastrectomy, subtotal gastrectomy, vagotomy with gastrectomy, resection of the small intestine) lead to the development of gland deficiency. In persons who have undergone gastrectomy, iron deficiency is initially latent, 1–3 years after the surgery, IDA develops. The latter is caused by impaired absorption, assimilation and exchange of iron in the post-resection period. Enterogenous anemia may result from impaired iron absorption during resections of a significant part of the small intestine and enteritis of various origins. Often, agastral and enterogenic anemias are accompanied by deficiency not only of iron, but also vitamin B12, folic acid, proteins, which gives them a mixed character.
Also, iron deficiency could occur due to insufficient intake of iron from food. Severely restricting iron-rich foods while dieting due to underlying gastroenterological disease, religious and traditional customs, vegetarianism, general decline in the socio-economic standard of living of patients - all these factors determine the IDA development.
The underlying principles of IDA treatment are therapy of the digestive system underlying disease, which is the cause of its development, as well as the replacement of iron deficiency in the blood and tissues, and achievement of complete clinical and hematological remission.
I.E. Kushnir. Sindrom anemii v gastroenterologii. Ostrye i neotlozhnye sostoyaniya v praktike vracha. 2 (26) ' 2011
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