Investigations for iron deficiency anaemia (IDA) in our hospital compared to British Society of Gastroenterology (BSG) guidelines 2011

Aims: To analyse investigations performed in patients presenting with iron deficiency anaemia (IDA) in our hospital and to compare them to British Society of Gastroenterology (BSG) guidelines issued in 2011. Methods: We performed a retrospective analysis of 298 patients who had either upper or lower gastrointestinal (GI) tract investigated for iron deficiency anaemia over a period of two years from 1 st February 2012 to 31 st January 2014 in our hospital. Out of these 298 patients only 151 (50.6%) had low haemoglobin (Hb) and serum ferritin of less than 12 µg/l. These 151 patients were considered to have iron deficiency anaemia as per BSG guidelines and were recruited in our study. Results: 140 (92.7%) of these 151 patients with IDA had oesophagogastroduodenoscopy (OGD) and 122 (80.73%) had either colonoscopy or barium enema. 114 (75.4%) out of 151 patients had both upper and lower gastrointestinal (GI) tract investigated completely. In 74 (49%) out of 151 patients no cause for anaemia was found. In patients where a cause was found gastritis was the most common cause (n=20) followed by colonic carcinoma (n=11) and oesophagitis (n=10). Only 51 (36.4%) out of 140 patients who had OGD had duodenal biopsy and seven of these showed coeliac disease. Overall, 13 (8.6%) patients out of 151 had identifiable causes for anaemia in both upper and lower GI tract. In 100 (66.2%) out of 151 patients investigations fell short of guidelines. Conclusion: Incomplete investigation of IDA is common practice in our hospital. Both upper and lower GI pathology was present in 8.6% of patients who had IDA. These patients should be investigated completely as per BSG guidelines in order to make an accurate diagnosis.