Oral iron replacement therapy is associated with a number of adverse effects on the gastrointestinal tract. These can be a reason for noncompliance.
Common complications of oral iron therapy:
(1) nausea
(2) change in bowel habits (constipation, diarrhea)
(3) gastritis or dyspepsia
(4) esophageal ulceration
Less specific problems:
(5) altered gut microbiome
(6) increased gastrointestinal inflammation and/or mucosal injury
Steps that may improve oral iron therapy:
(1) reduce iron dose
(2) alternate day dosing
(3) take with food
(4) avoid taking with fiber, tea and coffee
(5) discontinue proton pump inhibitor
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Specialty: Gastroenterology
