Endoscopy of the Gut: A Window into the Puzzle of Iron-deficiency Anemia

Background: Iron-deficiency anemia (IDA) is the most common form of anemia which affects almost every age group. It impacts with varied severity the quality of life of the person affected. IDA is caused by either decreased availability of food, especially during times of increased requirement or decreased absorption from the gastrointestinal (GI) tract or increased loss due to various reasons in different age groups. We tried to estimate the prevalence of GI causes in patients with IDA in a tertiary care hospital and describe the clinicopathological profile of the patients with IDA. Materials and Methods: A cross-sectional observational study was conducted in a tertiary care center in Western India on patients suffering from IDA. Male patients of >18 years and female patients >45 years with IDA and no known chronic disease or infection were included in the study and their endoscopic/colonoscopic findings were recorded and analyzed. A biopsy was taken, whenever deemed relevant. Advanced procedures such as enteroscopy or capsule endoscopy were not performed on these patients. Results: A total of 120 patients were evaluated for IDA. At least one GI lesion was found in 42.5% (n = 51) of patients. Upper GI (UGI) lesions (27.5%) were most commonly encountered, followed by lower GI lesions (9.1%). Conclusion: The patients with unexplained IDA were found to have a high incidence of GI lesions (42.5%). Hence, evaluation of the GI system with UGI endoscopy, colonoscopy, and mucosal biopsies in relevant patients is recommended for the determination of the cause of anemia.