Fermín Mearin¹, Ángel Lanas², Luis Bujanda³, Pilar Canelles⁴, José Cotter⁵, Antonio Hervás⁶, Carlos Martín de Argila⁷, Miguel Montoro⁸, Javier P. Gisbert⁹

¹ Servicio de Gastroenterología, Centro Médico Teknon, Barcelona, Spain

² Servicio de Enfermedades Digestivas, Hospital Universitario, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínico Universitario, Zaragoza, Spain

³ Departamento de Gastroenterología, Hospital Donostia/Instituto Biodonostia; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Universidad del País Vasco (UPV/EHU), San Sebastián, Spain

⁴ Servicio de Patología Digestiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain

⁵ Departamento de Gastroenterología, Hospital da Senhora da Oliveira, Guimarães, Portugal; Instituto de Investigación en Ciencias de la Vida y la Salud (ICVS), Escuela de Ciencias de la Salud, Universidad de Minho, Portugal; ICVS/3B’s, Laboratorio Asociado al Gobierno de Portugal, Braga/Guimarães, Portugal

⁶ Servicio de Digestivo, Hospital Universitario Reina Sofía, Córdoba, Spain

⁷ Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain

⁸ Departamento de Gastroenterología, Hospital General San Jorge, Huesca, Spain

⁹ Servicio de Aparato Digestivo, Hospital Universitario de La Princesa e Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain

Abstract
Despite high prevalence of iron deficiency anemia (IDA) in patients with acute or chronic gastrointestinal bleeding (GIB), IDA and iron deficiency (ID) are frequently untreated.
Reasons may be misconceptions about the impact and diagnosis of IDA and the efficacy of new treatments. Addressing these misconceptions, this article summarizes current evidence for better understanding and management of GIB-associated IDA. Despite only few controlled studies evaluated the efficacy of iron treatment in patients with GIB, there is consistent evidence suggesting that: (a) IDA should be diligently investigated, (b) effective treatment of ID/IDA improves outcomes such as health-related quality of life and can avoid severe cardiovascular consequences, and (c) intravenous iron should be considered as well-tolerated treatment in this setting. Overall, the misconceptions and practices outlined in this article should be replaced with strategies that are more in line with current guidelines and best practice in GIB and other underlying conditions of ID/IDA.
© 2017 The Author(s). Published by Elsevier Espa˜na, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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