doiSerbia

Upper and lower gastrointestinal endoscopy in patients with iron deficiency anemia

Popović Dušan Đ. (Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Zec Simon (University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Ranković Ivan V. (Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia)
Glišić Tijana M. (Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Milovanović Tamara M. (Clinical Centre of Serbia, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)

Introduction/Objective. The most common cause of iron deficiency anemia (IDA) in both men and postmenopausal women are gastrointestinal diseases. This study aimed to determine the frequency of pathological and diagnostic findings observed on esophagogastroduodenoscopy (EGDS) and colonoscopy in IDA patients, and examine associations between demographic, anamnestic, and clinical features, with findings found on endoscopy. Methods. A retrospective cross section study of patients with IDA was conducted. Results. Eighty-five patients with IDA were included, mean age of 60.3 ± 18.8 years, with 51.8% being women. Esophagogastroduodenoscopy, colonoscopy, or both was performed in 96.5%, 71.8%, and 70.6% of patients, respectively. The cause of IDA was established in 65.9% of cases. Diagnostic findings were observed in those who underwent EGDS, colonoscopy, or both in 43.9%, 47.5%, and 15.9% of patients, respectively. Diagnostic findings on EGDS were significantly more common in patients older than 50 years then in younger patients (p = 0.031). Patients with a diagnostic finding on colonoscopy more commonly reported weight loss (p = 0.046) and change in bowel habit (p = 0.012), alongside positive fecal occult blood test (FOBT; p = 0.012); they rarely had anemia previously (p = 0.001), rarely used iron supplements (p = 0.022), and were more likely to have malignancy in their past medical history (p = 0.043). Conclusion. Diagnostic findings on EGDS were more commonly observed in older patients, while diagnostic findings on colonoscopy were more common in those with weight loss, change in bowel habit, positive FOBT, and prior malignancy. Colonoscopy was more often diagnostic in patients without anemia or iron supplementation in the past.

Keywords: anemia, endoscopy, neoplasm, angiodysplasia