AI Article Synopsis
- Chronic gastrointestinal bleeding is the main cause of iron deficiency anemia (IDA) in men over 50 and post-menopausal women, yet there's limited research on IDA in patients without GI symptoms.
- In a study of 48 asymptomatic IDA patients, 29% had lesions causing anemia in the upper GI tract, and 33% in the lower tract, with a notable 29% incidence of malignancy, mainly right-sided colon cancer.
- The findings suggest that thorough GI examinations, especially of the right colon, are essential for men over 50 and post-menopausal women with asymptomatic IDA due to the high risk of malignancies.
Article Abstract
Background And Objectives: Chronic gastrointestinal (GI) bleeding is the leading cause of iron deficiency anaemia (IDA) in men older than 50 years and post-menopausal women. There is a scarcity of data regarding IDA patients without GI symptoms or signs. We conducted a prospective study to determine the prevalence and the locations of the GI tract lesions in patients with asymptomatic IDA.
Methods: Forty-eight patients with asymptomatic IDA (25 men older than 50 years and 23 post-menopausal women) underwent colonoscopy, gastroscopy and abdominal computed tomography (CT) with contrast agent.
Results: An anaemia-causing lesion was found in 14 (29%) and 16 (33%) patients in the upper and the lower GI tract, respectively. The prevalence of dual lesions (in both the upper and lower GI tract) was low (6%). In 14 (29%) patients, a malignancy, predominantly right-sided colon carcinoma, was responsible for the IDA. Only one patient had a lesion in the small bowel. In 14 (29%) patients, the work-up was negative.
Conclusion: Our prospective study demonstrates a high rate of malignancy, predominantly right-sided colon carcinoma, in men older than 50 years and post-menopausal women with asymptomatic IDA. This finding obligates a complete and rigorous GI tract examination in this group of patients, especially of the right colon.
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| http://dx.doi.org/10.1093/fampra/cmh705 | DOI Listing |
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