Researchers studied 160 children with inflammatory bowel disease (IBD), a condition that causes swelling in the digestive system. They found that about 6 out of 10 kids had anemia (low red blood cells) when first diagnosed, but this improved to about 1 out of 4 after one year of treatment. The most common cause was iron deficiency, but some kids had multiple types of anemia at the same time. Even with treatment, about one-third of children still had anemia after a year, suggesting doctors need better ways to monitor and treat this problem in young patients.

The Quick Take

  • What they studied: How often anemia (low red blood cell count) happens in children with inflammatory bowel disease, what causes it, and whether it gets better with treatment over one year
  • Who participated: 160 children with inflammatory bowel disease, average age about 13 years old, with slightly more boys than girls
  • Key finding: About 62% of children had anemia when diagnosed with IBD, but this dropped to 26% after one year of treatment. However, one-third of kids still had anemia even after a year, showing that treatment doesn’t always completely fix the problem
  • What it means for you: If your child is diagnosed with IBD, doctors should regularly check for anemia and its causes. While treatment helps many kids, some may need extra attention and different approaches to fully recover their red blood cell levels

The Research Details

This was a retrospective study, meaning researchers looked back at medical records of 160 children who had already been diagnosed with inflammatory bowel disease. They collected information about each child’s age, symptoms, blood test results, and treatments. They specifically looked at blood tests taken when the child was first diagnosed and again one year later to see how anemia changed over time.

The researchers identified different types of anemia by examining blood test results. They looked for iron deficiency (not enough iron), anemia of chronic disease (caused by long-term illness), vitamin B12 deficiency, and folic acid deficiency. This allowed them to understand not just whether kids had anemia, but why they had it.

Understanding what causes anemia in children with IBD is important because different causes need different treatments. If a child has low iron, they need iron supplements. If they have vitamin B12 deficiency, they need B12 treatment. By looking at real patient records over time, researchers could see which treatments worked and which kids still struggled, helping doctors improve care

This study looked at actual patient records, which gives real-world information. However, because it’s retrospective (looking backward), doctors may have missed some information or not tested all patients the same way. The study included a decent number of children (160), which makes the findings more reliable than a smaller study. The researchers measured multiple types of anemia, which is more thorough than just checking if anemia was present or not

What the Results Show

When children were first diagnosed with IBD, anemia was very common: 62% had low red blood cells. The most frequent cause was iron deficiency, found in 59% of children at diagnosis. Another major cause was anemia of chronic disease (caused by the long-term inflammation), found in 54% of kids at diagnosis.

After one year of treatment, the situation improved significantly. Only 26% of children still had anemia, and iron deficiency dropped to 26%. Anemia of chronic disease fell to 13%. This shows that treatment helps many children recover their red blood cell levels.

However, the study revealed an important problem: about one-third of children still had anemia after one year despite receiving treatment. Additionally, more than half of the children had multiple types of anemia at the same time when first diagnosed, meaning their low red blood cells were caused by more than one problem (like both iron deficiency and chronic disease anemia together).

Children with more severe IBD symptoms were more likely to have anemia than those with mild symptoms, suggesting that controlling the gut inflammation is important for preventing anemia.

Vitamin B12 deficiency was found in 21% of children at diagnosis but dropped to 10% after one year. Folic acid deficiency was present in 14% at diagnosis and decreased to 4% after treatment. These improvements suggest that treatment helps address multiple nutritional deficiencies that develop from IBD. The fact that some children had mixed causes of anemia highlights how complicated this problem can be in kids with IBD

This study is one of the first to carefully track multiple types of anemia in children with IBD from diagnosis through one year of follow-up. Previous research showed that anemia is common in IBD, but this study provides more detail about the different causes and how they change with treatment. The finding that one-third of children remain anemic despite treatment is concerning and suggests that current treatment approaches may not be adequate for all children

This study looked backward at medical records, so some information might be incomplete or recorded differently by different doctors. The study only followed children for one year, so we don’t know what happens in the longer term. The study didn’t explain exactly what treatments each child received, so we can’t say which specific treatments work best. The study was done at one hospital or clinic, so results might be different in other places with different patient populations or treatment approaches

The Bottom Line

If your child is diagnosed with IBD, ask your doctor to check for anemia through blood tests. If anemia is found, ask what’s causing it (iron deficiency, vitamin deficiency, or chronic disease anemia) because different causes need different treatments. Regular blood tests during the first year of treatment are important to make sure the anemia is improving. If your child still has anemia after one year of treatment, discuss with your doctor whether a different approach might help. These recommendations are based on solid evidence from this study but should be discussed with your child’s doctor

Parents and caregivers of children newly diagnosed with IBD should pay attention to this research. Children with moderate to severe IBD symptoms are at higher risk. Healthcare providers treating children with IBD should use this information to improve their monitoring and treatment of anemia. This research is less relevant for adults with IBD, as their anemia may have different causes and patterns

Most children showed improvement in anemia within the first year of treatment, with the biggest improvements typically seen in the first few months. However, some children took longer, and about one-third still had anemia at the one-year mark. Realistic expectations are that treatment will help many children, but some may need ongoing monitoring and adjustments to their treatment plan

Want to Apply This Research?

  • Track hemoglobin levels (the protein in red blood cells that carries oxygen) from blood tests every 3 months. Record the specific type of anemia if known (iron deficiency, B12 deficiency, etc.) and any iron or vitamin supplements being taken. Note energy levels and symptoms like tiredness or shortness of breath
  • Work with your doctor to ensure your child takes prescribed iron or vitamin supplements consistently. Track supplement adherence in the app. Monitor dietary iron intake (red meat, beans, fortified cereals) and discuss with a dietitian. Record any side effects from supplements to discuss with the doctor
  • Set reminders for regular blood tests (every 3 months during the first year). Create a chart showing hemoglobin trends over time to share with your doctor. Track symptoms that might indicate worsening anemia (increased fatigue, pale skin, shortness of breath). Note any changes in IBD symptoms, as better disease control often leads to better anemia control

This research summary is for educational purposes only and should not replace professional medical advice. Anemia in children with IBD requires individualized evaluation and treatment by qualified healthcare providers. If your child has been diagnosed with IBD or shows signs of anemia (fatigue, pale skin, shortness of breath), consult with your pediatrician or gastroenterologist for proper testing and treatment. Treatment decisions should be based on your child’s specific situation, not general research findings. Always discuss any concerns about your child’s blood health with their healthcare team before making changes to treatment or supplements.