What laboratory finding is most consistent with active inflammatory bowel disease?

• A. Leukocytosis with elevated CRP
• B. Iron overload with decreased ESR
• C. Hyperkalemia with normal inflammatory markers
• D. Anemia from chronic blood loss with elevated CRP or ESR indicating inflammation

Answer: (D)

Active inflammatory bowel disease commonly drives systemic inflammation, which shows up as elevated inflammatory markers like CRP and ESR. At the same time, ongoing GI bleeding from inflamed intestinal mucosa often leads to iron-deficiency anemia. So, when you see anemia from chronic blood loss together with elevated CRP or ESR, it strongly indicates active inflammatory activity in the gut. Leucocytosis with elevated CRP can occur during flares but is less specific, while iron overload with a decreased ESR or hyperkalemia with normal inflammatory markers don’t fit the typical pattern of active IBD.