Gastrointestinal evaluation in iron deficiency anaemia

Introduction: Unexplained iron deficiency anaemia in adult population is thought to be due to occult blood loss in the gastrointestinal tract.
Aim: To prospectively study the gastrointestinal lesions associated with IDA.
Materials and methods: We prospectively studied 118 consecutive patients with unexplained IDA during the study period with upper GI endoscopy. Colonoscopy was done in patients with negative findings in endoscopy. In patients were both failed to show lesions, video capsule endoscopy was done to evaluate small bowel. A questionnaire was used to study the associated GI symptoms.
Results: Upper GI endoscopy, colonoscopy and video capsule endoscopy detected lesions in 63.6 %, 11.9 % and 7.6 % patients respectively. No cause was detected in 16.1 % of patients. Upper GI symptoms (48.3 %) were more commonly seen than the lower (15.3 %), with heartburn and dysphagia predominating. The sensitivity and specificity of upper GI symptoms was 60 % and 72 % and 31 % and 87 % for lower GI symptoms.
Conclusion: Patients with unexplained IDA should be screened with upper GI endoscopy despite the absence of GI symptoms. IDA serves as a marker to detect newer GI malignancies.