Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2020; 26(45): 7242-7257
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7242
Diagnosis and treatment of iron-deficiency anemia in gastrointestinal bleeding: A systematic review
José Cotter, Cilénia Baldaia, Manuela Ferreira, Guilherme Macedo, Isabel Pedroto
José Cotter, Department of Gastroenterology, Hospital da Senhora da Oliveira-Guimarães, Guimarães 4835-044, Portugal
José Cotter, Department of Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga 4710-057, Portugal
José Cotter, Department of Life and Health Sciences Research Institute (ICVS)/3B’s, PT Government Associate Laboratory, Braga 4710-057, Portugal
Cilénia Baldaia, Department of Gastroenterology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon 1649-035, Portugal
Cilénia Baldaia, Department of University Clinic of Medicine II, Faculty of Medicine, University of Lisbon, Lisbon 1649-028, Portugal
Manuela Ferreira, Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal
Manuela Ferreira, Department of Faculty of Medicine, University of Coimbra, Coimbra 3004-504, Portugal
Guilherme Macedo, Department of Gastroenterology, Centro Hospitalar de São João, Porto 4200-319, Portugal
Guilherme Macedo, Department of Gastroenterology, Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
Guilherme Macedo, Department of Gastroenterology and Hepatology Training Center, World Gastroenterology Organization, Porto 4200-319, Portugal
Isabel Pedroto, Department of Gastroenterology, Centro Hospitalar do Porto, Porto 4099-001, Portugal
Isabel Pedroto, Department of Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto 4050-313, Portugal
Author contributions: Cotter J, Baldaia C, Ferreira M, Macedo G, and Pedroto I conceived and designed the work; Cotter J, Ferreira M, Macedo G, and Pedroto I analyzed and interpreted the literature; Cotter J drafted the manuscript; Cotter J, Baldaia C, Ferreira M, Macedo G, and Pedroto I revised the manuscript for intellectual content; all authors reviewed and approved the final manuscript.
Supported by OM Pharma (Amadora, Portugal) for payment for medical writing support.
Conflict-of-interest statement: Author Cilénia Baldaia has received fees for serving as a speaker, consultant and/or advisory board member from CSL Behring and OM Pharma. Author Isabel Pedroto has received fees for serving as a speaker, consultant and/or advisory board member from Abbvie, Gilead, and MSD. Authors José Cotter, Manuela Ferreira, and Guilherme Macedo declare that they have no competing interests relevant to this work.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: José Cotter, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology, Hospital da Senhora da Oliveira-Guimarães, Rua dos Cutileiros, Creixomil, Guimarães 4835-044, Portugal. jcotter@hospitaldeguimaraes.min-saude.pt
Received: June 1, 2020
Peer-review started: June 1, 2020
First decision: June 12, 2020
Revised: July 10, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: December 7, 2020
Core Tip

Core Tip: Iron-deficiency anemia (IDA) is a public health issue often caused by gastrointestinal bleeding. Few clinical practice guidelines regarding the appropriate investigation of IDA due to gastrointestinal bleeding were published. Therefore, five gastroenterology experts conducted a systematic search in PubMed and medical association websites to analyze the current evidence and guidelines on IDA management in patients with gastrointestinal bleeding. From 494 search results, 13 clinical practice guidelines, 17 original articles, and one meta-analysis were analyzed. Ten recommendations were developed for screening, treatment indications, appropriate therapies, and treatment goals, being a starting point for diagnosing and treating IDA in gastrointestinal bleeding patients.