Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms

Iron deficiency (ID) is the most frequent nutritional deficiency in the whole population worldwide, and the second most common cause of anemia in the elderly. The prevalence of anemia is expecting to rise shortly, because of an ageing population. Even though WHO criteria define anemia as a hemoglobin serum concentration <12 g/dL in women and <13 g/dL in men, several authors propose different and specific cut-off values for the elderly. Anemia in aged subjects impacts health and quality of life, and it is associated with several negative outcomes, such as longer time of hospitalization and a higher risk of disability. Furthermore, it is an independent risk factor of increased morbidity and mortality. Even though iron deficiency anemia is a common disorder in older adults, it should be not considered as a normal ageing consequence, but a sign of underlying dysfunction. Relating to the molecular mechanism in Iron Deficiency Anemia (IDA), hepcidin has a key role in iron homeostasis. It downregulates the iron exporter ferroportin, inhibiting both iron absorption and release. IDA is frequently dependent on blood loss, especially caused by gastrointestinal lesions. Thus, a diagnostic algorithm for IDA should include invasive investigation such as endoscopic procedures. The treatment choice is influenced by the severity of anemia, underlying conditions, comorbidities, and the clinical state of the patient. Correction of anemia and iron supplementation should be associated with the treatment of the causal disease.

Download Full-text

DETECTION OF GASTROINTESTINAL LESIONS CAUSING IRON DEFICIENCY ANEMIA USINGGASTROINTESTINAL ENDOSCOPY

Al-Azhar Medical Journal ◽

10.21608/amj.2022.212639 ◽

2022 ◽

Vol 51 (1) ◽

pp. 485-494

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Deficiency Anemia ◽

Gastrointestinal Lesions

Download Full-text

Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms

The American Journal of Medicine ◽

10.1016/s0002-9343(01)00883-x ◽

2001 ◽

Vol 111 (6) ◽

pp. 439-445 ◽

Cited By ~ 126

Author(s):

Bruno Annibale ◽

Gabriele Capurso ◽

Antonio Chistolini ◽

Giancarlo D’Ambra ◽

Emilio DiGiulio ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Gastrointestinal Symptoms ◽

Deficiency Anemia

Download Full-text

Gastrointestinal Lesions in African American Patients With Iron Deficiency Anemia

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552218778627 ◽

2018 ◽

Vol 11 ◽

pp. 117955221877862 ◽

Cited By ~ 1

Author(s):

Hassan Brim ◽

Anahita Shahnazi ◽

Mehdi Nouraie ◽

Dilhana Badurdeen ◽

Adeyinka O Laiyemo ◽

...

Keyword(s):

African American ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Clinical Laboratory ◽

Demographic Data ◽

Deficiency Anemia ◽

Gi Bleeding ◽

Associated Lesions ◽

Asymptomatic Patients ◽

Gastrointestinal Lesions

Background: Iron deficiency anemia (IDA) is a frequent disorder that is associated with many serious diseases. However, the findings of an evaluation of IDA-associated gastrointestinal disorders are lacking among African American patients. Aim: To determine the most prevalent gastrointestinal lesions among African American patients with IDA especially in young men. Methods: We reviewed medical records (n = 422) of patients referred for evaluation of IDA from 2008 to 2012. Iron deficiency anemia was diagnosed using clinical laboratory tests. The results of esophagogastroduodenoscopy, colonoscopy, and pathology specimens along with demographic data were abstracted and analyzed using Stata. Results: The mean age was 61.9 years, and 50.5% were women. In total, 189 patients (45%) had gross gastrointestinal (GI) bleeding. The most frequent diagnoses were gastritis (40%), benign colonic lesions (13%), esophagitis (9%), gastric ulcer (6%), and duodenitis (6%). GI bleeding was significantly more frequent in men ( P = 0.001). Benign and malignant colonic lesions were significantly more present among older patients: 16% vs 6% ( P = .005) and 5% vs 0% ( P = .008), respectively. Colitis was more prevalent in younger patients (⩽50): 11% vs 2% ( P = .001). In patients with gross lower GI bleeding, the top diagnoses were gastritis (25%), benign colon tumors (10%), and duodenitis (6%). Colon cancer was diagnosed among 15 patients, and all these patients were older than 50 years of age. Conclusions: Gastritis and colonic lesions are most common associated lesions with IDA among African Americans. So bidirectional endoscopy is required for unrevealing of the cause of IDA in asymptomatic patients.

Download Full-text

Identification of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron deficiency anemia

International Journal of Medical Sciences ◽

10.7150/ijms.8.30 ◽

2011 ◽

Vol 8 (1) ◽

pp. 30-38 ◽

Cited By ~ 6

Author(s):

Songul Serefhanoglu ◽

Yahya Buyukasik ◽

Hakan Emmungil ◽

Nilgun Sayinalp ◽

Ibrahim Celalettin Haznedaroglu ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Deficiency Anemia ◽

Gastrointestinal Lesions ◽

Laboratory Variables

Download Full-text

Iron supplementation during pregnancy: what are the risks and benefits of current practices?

Applied Physiology Nutrition and Metabolism ◽

10.1139/h07-012 ◽

2007 ◽

Vol 32 (2) ◽

pp. 282-288 ◽

Cited By ~ 27

Author(s):

France M. Rioux ◽

Caroline P. LeBlanc

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anemia ◽

Iron Supplementation ◽

Current Knowledge ◽

Iron Status ◽

Gastrointestinal Symptoms ◽

Deficiency Anemia ◽

Dietary Reference Intake ◽

Daily Dose

Iron-deficiency anemia is still prevalent among pregnant women living in industrialized countries such as Canada. To prevent this deficiency, iron supplements (30 mg/d) are routinely prescribed to Canadian pregnant women. Recently, dietary reference intakes for iron have increased from 18 and 23 mg/d during the second and third trimesters, respectively, to 27 mg/d throughout the pregnancy for all age groups. Whether this new recommendation implies an increase of iron dosage in supplements has not been answered. Are there any benefits or risks for the mother and her infant associated with iron supplementation during pregnancy? If iron supplementation is recommended, what should be the ideal dosage? This article reviews current knowledge on the potential negative or positive impact of iron supplementation during pregnancy on the outcomes of both infants and mothers. Based on the literature reviewed, a low daily dose of iron (30 mg elemental iron) during pregnancy improves women’s iron status and seems to protect their infants from iron-deficiency anemia. Several studies have also shown that a low daily dose of iron may improve birth weight even in non-anemic pregnant women. However, higher dosages are not recommended because of the potential negative effects on mineral absorption, oxidative pathways, and adverse gastrointestinal symptoms. To date, it is still not clear if health professionals should recommend routine or selective supplementation. However, neither routine nor selective iron supplementation during pregnancy is able to eliminate iron-deficiency anemia. Even though the dietary reference intake for iron during pregnancy has been recently increased, we do not recommend higher doses of iron in supplements designed for pregnant women.

Download Full-text