Cancer Support India

Sunday, September 13, 2026

Anaemia Remains Common in Paediatric IBD

Key Summary:

Anaemia affected 52% of patients at paediatric IBD diagnosis.
Anaemia prevalence fell to 25% by year five after diagnosis.
Iron deficiency anaemia plus anaemia of chronic disease was the most common anaemia subtype at diagnosis.

Anaemia was common among patients with paediatric-onset inflammatory bowel disease (PIBD) at diagnosis and remained associated with disease activity during the following five years, according to a Danish nationwide cohort study.

Anaemia Common at PIBD Diagnosis

Researchers investigated the prevalence and subtypes of anaemia among patients aged 6–17 years diagnosed with PIBD between 2014 and 2022. They also examined whether anaemia was associated with disease activity over the five years following diagnosis.

The study used Danish national health registers to identify 1,266 incident patients with PIBD. Anaemia was defined according to WHO criteria, while anaemia subtypes were classified using guidelines from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition.

At diagnosis, 660 patients, equivalent to 52% of the cohort, had anaemia. Although prevalence declined during follow-up, anaemia remained present in 25% of patients in year five.

Mixed Anaemia Subtype Predominates

The severity of anaemia changed over time. Moderate anaemia was most frequently observed at diagnosis and during the first year, whereas mild anaemia became more common in subsequent years.

Among patients who had anaemia at diagnosis, 237 could be assigned an anaemia subtype. Iron deficiency anaemia (IDA) was identified in 25 patients, representing 11%, while 44 patients, or 19%, had anaemia of chronic disease (ACD). The largest group had both IDA and ACD, affecting 168 patients, or 71%.

These findings indicated that combined iron deficiency and chronic disease contributed substantially to the anaemia observed at PIBD diagnosis.

Anaemia Associated with Disease Activity

The study also found an association between anaemia and disease activity throughout the five-year follow-up period. Disease activity was assessed using medication use, surgical procedures, and hospitalisation.

The strongest association was observed in year four, when patients with anaemia had more than twice the risk of disease activity compared with those without anaemia (adjusted risk ratio: 2.3; 95% CI: 1.8–3.0).

The researchers concluded that anaemia represented a frequent feature of PIBD, particularly at diagnosis, and remained prevalent despite declining over time. The persistent association between anaemia and disease activity further highlighted its relevance during follow-up. The findings also identified IDA combined with ACD as the predominant subtype at diagnosis.

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Labels: anaemia, inflammatory bowel disease(IBD), iron deficiency, paediatric diagnosis

Listen to women in pain

In college, I had a friend who felt compelled to attend classes and theatre practice, despite debilitating pain, on the first day of her period. On more than one occasion, in the middle of practice, I was met with the sight of blood pooling at her feet. In my early teen years, when I experienced irregular and painful periods, the doctor informed me that I was “just not used to” the monthly cycle of blood and discomfort. When abnormal hormonal fluctuations triggered an autoimmune condition, one which leaves me bedridden for days at a time, doctors had no answers for me for a long time.

Recently, India’s first genome-wide study of endometriosis shed some light on the role genetics play in the manifestation of the condition. It is a great step in addressing the underrepresentation of South Asian people in the genetic research on the condition. It opens the door for more research, conversation, and a deeper understanding of a condition that has been criminally understudied and misunderstood.

While the broadening public dialogue and scientific research are positive signs, the larger question remains: Why are reproductive disorders so poorly understood? Why do women, across history and geographies, have their pain dismissed and minimised when they seek help?

The answer is as simple as it is unjust: Society and medicine still hesitate to take women and their pain seriously.

For 4,000 years, a wide range of physical and mental illnesses in women were labelled hysteria — with barely any cures beyond spells, sexual abstinence and condemnation. Today, it can take several years and doctors for women to be diagnosed with PMOS. For endometriosis, it can take up to 12 years for a confirmed diagnosis. In the meantime, the damage only compounds.

Across the world, and in India in particular, women are lauded for their pain tolerance — menstruation, childbirth and menopause — and derided if they complain. Author Hilary Mantel, in a 2004 essay on her experience with endometriosis, wrote, “People talked — and still do — of a ‘low-pain threshold’. I didn’t want anyone to think I had that.” Thankfully, she didn’t have that. Instead, several years later, of course, she discovered what she had was endometriosis. And the payment for the diagnosis was “part of my bladder and my bowel, my womb and my ovaries.”

In India, in particular, where menstruation is still considered a taboo in large swathes of the country, and speaking of reproductive health, let alone any abnormalities around it, is shrouded in shame, fear, and ignorance, the conversation is far from where it needs to be. Chronic pain and illness are an incredibly isolating reality to contend with. Having that experience compounded by stigma, cruelty, and gendered bias makes the cost much higher for women’s physical and mental health and future.

After 12 years of hospital visits and unexplained illness, my friend was finally diagnosed with endometriosis. A delayed diagnosis culminated in several surgeries, and an adequate resolution remains a pipe dream. At 17, I was diagnosed with Polyendocrine Metabolic Ovarian Syndrome (PMOS). A few years after that, I finally had a diagnosis for the autoimmune condition. By then, the damage was serious enough that even with the best care, a surgery, at this point, seems unavoidable.

A society that refuses to treat its women with care and their pain with dignity can only reproduce similar patterns in medicine. This is why medicine alone cannot do the work. It needs a society that doesn’t rank women’s pain, one that cares enough to listen. The question is: Do we care enough to change?