Anemic Syndrome and Molecular Mechanisms and Regulation of Iron Absorption in Gastroenterological Diseases

Abstract

Anemic syndrome is the most often extraintestinal complication in patients with diseases of the digestive tract (DT), which can significantly impair the quality of life. In the literature review, we tried to combine and systematize the accumulated information on the problem of anemic syndrome in DT diseases. Iron-deficiency anemia, chronic disease anemia, B12-deficiency and folio-deficiency anemia are determined depending on the combination of pathogenetic mechanisms. Other variants of anemia are rare. It is necessary to carry out a complex laboratory examination to establish the leading factor in the development of anemia and determine the adequate therapy. Anemia of inflammatory disease is one of the frequent complications in patients with DT diseases. For the correction of such anemia in clinical practice, iron preparations are used parenterally. However, such therapy can lead to an excess of iron and worsen the course of the underlying disease. The understanding the anemia pathogenesis is important for prescribing therapy and minimizing the risk of complications. Parenteral forms of iron and vitamin preparations should be prioritized for this category of patients due to their higher bioavailability, low safety profile and minimal negative impact on DT. Erythropoietin preparations and inhibitors of proinflammatory cytokines are mainly used to correct anemia of chronic inflammation. Pro-inflammatory cytokines are effective for patients with anemic syndrome and severe inflammatory bowel processes. According to the literature data, various clinical studies aimed at the introduction of new drugs that correct anemia are being conducted. The review presents modern methods of diagnosis and treatment of anemia in order to better understand this disease. A further study of patients with gastroenterological diseases, the course of which is complicated by anemia, is necessary to form a final conclusion about the disease, the effectiveness and feasibility of prescribing parenteral forms of iron preparations.