What to expect when you need an iron infusion

If you have Crohn’s disease or ulcerative colitis, your doctor might tell you that your iron levels are low and you need an iron infusion. You might be wondering what that means, whether it will hurt, or what happens during the appointment.

First, take a deep breath! An iron infusion is a way of giving your body iron through a drip into a vein. It can help build up your iron levels when you don't have enough, especially if iron tablets haven't helped or aren't suitable for you.

Let's walk through what happens, step by step, so you know what to expect.

🩸 Why might you need an iron infusion?

Iron helps your body make haemoglobin, a protein in your red blood cells that carries oxygen around your body.

When you have IBD, your iron levels can become low for several reasons, including:

• Losing blood through your bowel.

• Inflammation making it harder for your body to use iron properly.

• Not getting enough iron from the food you eat.

• Having trouble absorbing enough iron from your digestive system.

Low iron can sometimes lead to iron deficiency anaemia, which means your body doesn't have enough healthy red blood cells or haemoglobin to carry oxygen around properly.

You might notice that you're feeling extra tired, dizzy, weak, or short of breath. You may also find it harder to concentrate at school or keep up with your usual activities.

An iron infusion can help restore your iron levels and may help you feel better as your body recovers.

💉 What is an iron infusion?

An iron infusion is a treatment that delivers iron directly into your bloodstream through a small tube called a cannula.

Unlike iron tablets, which you swallow, an infusion allows iron to enter your bloodstream without needing to be absorbed through your gut first.

Your doctor might recommend an infusion if:

• Your iron levels are very low.

• Iron tablets haven't worked well enough.

• Iron tablets cause tummy pain, nausea, constipation, or other side effects.

• Your IBD makes it difficult to absorb enough iron.

• You need to replace iron more quickly.

Depending on your iron levels, your weight, and the type of iron used, you may need one infusion or more than one.

🏥 Where will you have your iron infusion?

Your infusion will usually take place at a hospital or an infusion clinic, where healthcare professionals can look after you during the treatment.

You might have your infusion in a day treatment unit, which means you can usually go home afterwards rather than staying overnight.

Your doctor or nurse will explain where you need to go, how long your appointment is likely to take, and whether you need to do anything to prepare.

📝 How to prepare for your appointment

Before your infusion, your healthcare team will give you instructions about what to do.

Here are a few things that might help you get ready:

• Eat and drink as advised. You can usually eat and drink normally before an iron infusion unless your healthcare team tells you otherwise.

• Wear comfortable clothes. Choose something with sleeves that can be rolled up easily so the nurse can reach your arm.

• Bring something to do. A book, headphones, a tablet, or a game can help pass the time.

• Ask someone to come with you. A parent or trusted adult can help you feel more comfortable.

• Tell your team about allergies or previous reactions. It's important that they know about any medicines or treatments that have caused problems before.

If you're worried about needles, let your nurse know before the appointment. They can help you work out ways to make the experience less stressful.

💉 What happens during an iron infusion?

Knowing what will happen can make the appointment feel less scary. Here's what usually happens.

1. Checking your details

Your nurse will check your details, ask about your health and any allergies, and explain the treatment. They may check your temperature, pulse, and blood pressure.

2. Putting in a cannula

The nurse will place a small plastic tube called a cannula into a vein, usually in your hand or arm. You'll feel a quick pinch when the needle goes in, but the needle is removed, leaving the soft plastic tube in place.

3. Giving you the iron

The iron is given through the cannula, usually mixed with a fluid in a drip or administered according to the instructions for that particular product. The infusion may take around 15 minutes to an hour or longer, depending on the type of iron you're given.

4. Keeping an eye on you

Your healthcare team will monitor you during the infusion and check how you're feeling. Tell your nurse straight away if you notice anything unusual, such as itching, dizziness, a rash, or difficulty breathing.

5. Removing the cannula

Once the treatment is finished and your team is happy that you're okay, the cannula will be removed. A small dressing will be placed over the spot.

You can usually go home afterwards, but you'll need to follow your team's instructions about how long to stay for observation.

😬 Does an iron infusion hurt?

The infusion itself shouldn't usually hurt. You might feel a quick sting when the cannula is inserted, and you may notice some discomfort while it is in your arm.

Tell your nurse if the area around the cannula becomes painful, swollen, or uncomfortable during the infusion. Iron leaking outside the vein can sometimes irritate the skin and may cause long-lasting staining, so it's important to speak up straight away.

If you're nervous about the cannula, you can ask your healthcare team whether numbing cream is an option.

🤢 Can you get side effects?

Most people tolerate iron infusions well, but side effects can happen.

Some people experience:

• A headache.

• Feeling sick or nauseous.

• Dizziness.

• Flushing or feeling warm.

• Muscle or joint aches.

• Changes in blood pressure.

These symptoms are often mild, but you should tell your healthcare team if you feel unwell during or after your infusion.

Serious allergic reactions are rare but can happen. Get urgent medical help if you develop difficulty breathing, swelling of your lips or throat, or feel as though you're going to collapse.

Sometimes, tiredness, muscle aches, or joint aches can develop after the infusion rather than during it. Your healthcare team can explain what to look out for and what to do if you feel unwell at home.

🏡 What happens after your iron infusion?

After your infusion, you can usually go home the same day.

You might feel completely fine, or you may feel a little tired or have a headache. Follow any instructions your healthcare team gives you about resting, drinking fluids, and returning to your usual activities.

Your iron levels won't necessarily improve overnight. It can take days to weeks for your body to use the extra iron, and it may take longer for symptoms such as tiredness to improve.

Your doctor may arrange follow-up blood tests to check your iron levels and see how well the treatment has worked.

If you continue to feel very tired, dizzy, or short of breath, let your healthcare team know rather than assuming you just need to wait longer.

💪 Will an iron infusion give you more energy?

If low iron is causing your tiredness, an iron infusion may help you feel more energetic as your iron levels recover.

You might find it easier to concentrate at school, take part in sport, or enjoy your usual activities again.

However, if your tiredness is also caused by active IBD, poor sleep, or another problem, an iron infusion might not fix everything on its own.

Your IBD team can help work out what else might be contributing to how you feel.

💙 Remember, it's okay to ask for help

Having an iron infusion might feel a little scary if you've never had one before, but your healthcare team will explain what they're doing and help you feel as comfortable as possible.

You don't have to pretend you're not nervous. It's okay to ask questions, bring something to distract you, or tell your nurse if you need some reassurance.

The most important thing to remember is that you're not expected to know everything or handle it all on your own. Your healthcare team is there to help you, and your questions and feelings matter.