The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

Abstract

Anemia is not uncommon in premenopausal women. The purpose of this study was to determine the yield of endoscopy in premenopausal women with anemia. We identified and reviewed the medical records of 168 premenopausal women who underwent upper endoscopy and/or colonoscopy for the indication of iron deficiency anemia (IDA) during the years 1996 through 2005. Of the 168 patients, 100 (59.5%) underwent upper endoscopy and 155 (92.3%) underwent colonoscopy. Eighty-seven (51.8%) patients underwent both procedures. The mean age was 43.1 +/- 5.8 years. The mean hemoglobin was 10.2 +/- 1.3 g/dl. Upper gastrointestinal (GI) lesions potentially causative for anemia were found in 7 of 100 patients who underwent upper endoscopy (7%). Significant lower GI lesions were found in 6 of 155 (3.9%) of those who had a colonoscopy. Our data suggest that both upper endoscopy and colonoscopy were useful in the detection of significant gastrointestinal lesions in premenopausal women with anemia.

Prevalence of Celiac Disease in Patients With Iron Deficiency Anemia—A Systematic Review With Meta-analysis

“…Any disagreement between SM and ML was solved through consensus, or through mediation with JFL. Reasons for exclusion of the 50 excluded papers were: unclear inclusion criteria (definition of CD or IDA, n=15 [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] ); looked at refractory IDA or anemia of obscure origin (n=10 [58][59][60][61][62][63][64][65][66][67] ); full-text unavailable or not available in English (n=7 [68][69][70][71][72][73][74] ); high risk of selection bias (n=6 32,[75][76][77][78][79] ); looked at iron deficiency without anemia, or anemia not explicitly part of criteria (n=4 [80][81][82][83] ); looked at anemia in general, not IDA (n=3 [84][85][86] ); or other reason (small intestinal biopsy not performed (n=1 87 ), case report (n=1…”

Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement?

“…Nevertheless, significant GI lesions were seen in 38% and 37% of premenopausal patients who underwent OGD endoscopy and colonoscopy, respectively, highlighting the need, noted by others, 32 for close monitoring of patients in whom IDA persists despite treatment of non-GI causes. Not surprisingly, these lesions were more commonly detected in the lower than in the upper GI tract (20% vs 4%).…”

“…Importantly, the majority of lower GI cancers were found in the ascending colon and caecum, which are only accessible by colonoscopy, confirming this as procedure of first choice over flexible sigmoidoscopy. Nevertheless, significant GI lesions were seen in 38% and 37% of premenopausal patients who underwent OGD endoscopy and colonoscopy, respectively, highlighting the need, noted by others, 32 for close monitoring of patients in whom IDA persists despite treatment of non-GI causes. The yield of colon cancer and high-risk adenomas at colonoscopy demonstrated no relation with the results of FOBT and was approximately the same -about one in five patients -irrespective of whether FOBT was positive or negative or even performed.…”

Do Gastrointestinal Symptoms Affect the Endoscopic Outcome in Anemic Premenopausal Women Due to Iron Deficiency: A Multicenter Study From Basrah-Iraq

“…There are sparse data on IDA in PW because these patients are rarely referred for GI investigations [12], and there is no agreed-on consensus for endoscopic evaluation for asymptomatic PW [13,14]. Sporadic studies recommended bidirectional endoscopy (BDE) in the course of IDA evaluation of under-40-year-old PWs with IDA [8,15,16] even though significant GI pathologies were detected in published studies, with a substantial proportion of women with different GI malignancies being as high as 6% [5,7,8,17]. [17] or not [3].…”