Pattern of Endoscopic Findings in Patients with Unexplained Iron Deficiency Anaemia at Ismailia City

Abstract

Background and study aim: Iron deficiency anemia (IDA) is a common health condition, often caused by reduced iron absorption or gastrointestinal blood loss, but it can be challenging to diagnose, especially in the absence of specific gastrointestinal symptoms. This study addresses the difficulty in identifying underlying gastrointestinal causes of IDA.Patients and Methods: This cross-sectional study included 450 patients who were ≥18 years, admitted to Internal Medicine or Endemic Diseases departments, excluding patients with chronic liver/kidney disease, bleeding disorders, or other anemias. Data were retrospectively collected. All patients underwent clinical assessment, laboratory tests (CBC, iron profile, liver/renal function), and both upper and lower GI endoscopy. Informed consent was obtained prior to procedures.Results: This study included 450 patients with a mean age of 48 years with a predominance of females. Endoscopic findings revealed that 22.6% had normal esophagogastroduodenoscopy (EGD), with common diagnoses being GERD, gastritis, and duodenal ulcers, while colonoscopy identified internal piles, malignant colonic masses, and polyps as the most common colonoscopic findings with 50% of negative colonoscopy. Subgroup analysis showed significant gender and age differences in endoscopic findings, with older patients showing more severe gastrointestinal issues (malignant masses represent 7.2% vs. 2%, p=0.04) and symptomatic patients having more profound laboratory abnormalities and higher rates of positive endoscopic findings (83.4% vs. 54.3%, p<0.001).Conclusion: A significant proportion of patients presented with gastrointestinal abnormalities, with age and gender influencing the frequency and severity of these findings. Endoscopic procedures revealed various gastrointestinal conditions, emphasizing the need for careful investigation to identify underlying causes of IDA and guide appropriate treatment.