An approach to iron-deficiency anemia

Iron-deficiency anemia is a common reason for referral to a gastroenterolog ist. In adult men and postmenopausal women, gastrointestinal tract patholog y is often the cause of iron-deficiency anemia, so patients are frequently referred for endoscopic evaluation. Endoscopy may be costly and at times di fficult for the patient. Therefore, physicians need to know what lesions ca n be identified reliably and, more importantly, the importance of ruling ou t life-threatening conditions such as occult malignancy. Over the past deca de, a number of prospective studies have been completed that examined the y ield of endoscopy in the investigation of iron-deficiency anemia. The prese nt article provides a broad overview of iron-deficiency anemia, with partic ular emphasis on hematological. diagnosis, etiology, the use of endoscopy i n identifying lesions and iron-repletion therapy. Other clinical scenarios, including assessment of patients on anti-inflammatory or anticoagulation t herapy and patients with bleeding of obscure origin, are also addressed. Th e present article provides a diagnostic algorithm to iron-deficiency anemia , which describes a more systematic manner in which to approach iron-defici ency anemia.