Abstract
Background and Objective:Iron deficiency anemia (IDA) has been cited as the most common cause of anemia globally. Gastrointestinal (GI) lesions are amongst the common cause of IDA. Endoscopic evaluation is the most effective way to investigate the IDA. The aim of this study was to show the association of alarming GI symptoms with abnormal endoscopic findings and to cut off the burden and cost of unnecessary endoscopies.Methods:This is cross sectional study of anemic patient who underwent upper and lower GI endoscopies in Aga Khan University Hospital, Karachi between July-December 2016.Results:Total 243 patients were identified after excluding ineligible patients. The mean age of subjects was 31.9 ± 6.1 years with a slight over-representation of females (57.4%). 149 (61.31%) patients underwent only upper GI endoscopic evaluation, and 83 (34.15%) patients on whom bi-directional endoscopy was performed (upper and lower). The remaining 11 (4.52%) patients underwent colonoscopy only. 16 (6.6%) subjects had negative findings on evaluation, while gastritis and serious findings were observed in 175 (72.0%) and 52 (21.4%) patients respectively. We found that patients with alarm features such as dysphagia (aOR: 2.07, 95%CI: 0.12-34.1), altered bowel habits (aOR: 1.64, 95%CI: 0.44-6.09) and weight loss (aOR: 1.25 95%CI: 0.54-2.85) demonstrated higher odds of serious findings on endoscopic evaluation as compared to the reference category, however they were not independently associated.Conclusion:Most of our patients had non-malignant pathologies, while alarm features were not found to be useful predictors of serious findings.
Highlights
According to the World Health Organization anemia is defined as a hemoglobin (Hb) level of less than 12.0 g/dl in women and 13.0 g/dl in men.[1]
Endoscopies are an effective way for evaluating anemia in the hospital setting
We extracted data for 260 adult patients with iron deficiency anemia, aged between 18-40 years who presented for EGD or colonoscopy between July and December, 2016
Summary
According to the World Health Organization anemia is defined as a hemoglobin (Hb) level of less than 12.0 g/dl in women and 13.0 g/dl in men.[1] Iron deficiency anemia (IDA) has been cited as the most common cause of anemia globally.[2] Endoscopies are an effective way for evaluating anemia in the hospital setting. 149 (61.31%) patients underwent only upper GI endoscopic evaluation, and 83 (34.15%) patients on whom bidirectional endoscopy was performed (upper and lower). We found that patients with alarm features such as dysphagia (aOR: 2.07, 95%CI: 0.12-34.1), altered bowel habits (aOR: 1.64, 95%CI: 0.44-6.09) and weight loss (aOR: 1.25 95%CI: 0.54-2.85) demonstrated higher odds of serious findings on endoscopic evaluation as compared to the reference category, they were not independently associated. Conclusion: Most of our patients had non-malignant pathologies, while alarm features were not found to be useful predictors of serious findings
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