Gastrointestinal Tract Endoscopic Evaluation of Iron Deficiency Anemia Patients without Gastrointestinal Manifestations Tanta University Hospitals Experience

Aims: Endoscopic evaluation of symptomless IDA patients and related lesions.

Study Design: A Cross-sectional epidemiological study.

Place and Duration of Study: The hematology unit of the Internal medicine department in Tanta university hospital, the duration of the study was 6 months from 1 January to 31 June 2019.

Methodology: 100 consecutive patients with laboratory base diagnosis of IDA without GI symptoms were involved in the study and their clinical and biochemical variables were recorded. All patients underwent esophagogastroduodenoscopy (EGD) and colonoscopy. Endoscopic findings were documented as the presence/absence of bleeding-related lesions or other causes of IDA.

Results: Possible cause of anemia was found in 95% and bleeding related lesions were found in 70% of patients. Upper GIT lesions were found in 70% of patients with 42% bleeding related lesions. Lower GIT lesions were found in 33% of patients with 21% bleeding related lesions. On multivariable logistic regression: old age, low hemoglobin (HB), low serum ferritin, and positive fecal occult blood test (FOBT) were predictive factors for GIT lesions and cause of IDA.

Conclusion: Clinical and biochemical markers can predict GI lesions on endoscopy in IDA patients without GI symptoms. A high proportion of upper GI involvement makes EGD an initial endoscopic procedure however, a colonoscopy should be done in old age, and when upper GI lesions don't correlate with the severity of IDA.