Results of gastrointestinal evaluation in 90 hospitalized iron deficiency anemia patients

Background: Chronic occult blood loss from the gastrointestinal tract is wi dely accepted as a major cause of iron deficiency anemia. Objectives: To evaluate the diagnostic yield of gastroscopy, colonoscopy an d fecal occult blood testing of hospitalized IDA patients, plus follow-up. Methods: IDA was defined as hemoglobin <12.5 g/dl (men) and 11 g/dl (women) , and serum iron <50 g/dl. The study group comprised 90 patients(42% male) with a mean age of 65+/-15 years and mean Hb 8.1 g/dl. Results: Gastroscopy and colonoscopy revealed a bleeding source in 28.8% an d 14.4% respectively. Gastrointestinal symptoms were found in 23% of patien ts with diseases of the upper gastrointestinal tract and in 15.3% of the lo wer, The sensitivity of fecal occult blood tests in detecting lesions in th e lower and upper GI tracts was 100% and 30.7% respectively. Forty-four pat ients (48.9%) were discharged from the hospital with IDA of unknown origin. Over the following year, 20 of the 44 patients required further hospitaliz ation, and of these, 13 were found to have anemia. Of the remaining 24 pati ents who were not hospitalized again, 15 had anemia. Four patients (9%) had significant gastrointestinal lesions and two died during the follow-up. Conclusions: Fecal occult blood is a sensitive examination for lower but no t for upper GI tract lesions.