Iron Deficiency Anaemia

In the presence of true, proven iron deficiency, approximately 10% of males and non- menstruating females will have a significant GI problem underlying this.

• These individuals should be referred for appropriate GI investigations if they are sufficiently fit to undergo them
• Investigation of the upper and lower GI tract will be undertaken
  • Upper GI Endoscopy combined with either
  • Colonoscopy or CT colonography or minimal preparation CT scan
• Appropriate investigation will be at the discretion of the secondary care team and will depend on a patient’s age and general fitness (which may have to be determined by clinic visit first)
  • CT colonography will be offered to less fit patients or those who cannot tolerate colonoscopy*
  • Minimal prep CT (no purgative laxative preparation) will be reserved for the most frail patients where any investigation at all is appropriate*
  • *It would be useful to have up to date U&E’s for frail patients or those >80 years

GI investigations are not appropriate in other types of anaemia unless there are clear GI symptoms to be investigated

• Menstruating females should not undergo GI investigation in the absence of GI symptoms or a family history of colon cancer
  • Testing for Coeliac disease is appropriate in these patients
• GI investigations may be appropriate for patients >50 years (and without history of menorrhagia) with proven iron deficiency in the absence of anaemia

​Males and non-menstruating females who have Iron Deficiency Anaemia, in the absence of GI symptoms, should be referred using the Iron deficiency Anaemia pathway via Gastroenterology.