Results of gastrointestinal endoscopic examinations in patients with iron defıciency anemia

Year 2011, Volume: 38 Issue: 2, 155 - 159, 01.06.2011

Züleyha Akkan Çetinkaya Mesut Sezikli Fatih Güzelbulut M. Erhan Altınöz Ayça Değirmenci Yasemin Gökden Selvinaz Özkara Seçil Sağlam Ayşe Oya Kurdaş Övünç

https://doi.org/10.5798/diclemedj.0921.2011.02.0006

Abstract

Objectives: Endoscopic procedures are usually carried out in order to diagnose the cause of iron deficiency ane­mia (IDA). We aimed to evaluate endoscopic findings of our patients with iron deficiency anemia retrospectively. Materials and methods: We retrospectively reviewed our computerized data of patients who attended to Haydar­pasa Numune Education and Research Hospital Gastro­entology Endoscopy Unit between 2008 and 2010 years. Patients in whom upper gastrointestinal endoscopy and/or colonoscopy were performed in order to diagnose the cause of IDA were included in this study. Results: This study included 490 patients with iron defi­ciency anemia in whom upper gastrointestinal endoscopy and/or colonoscopy were performed. The mean age of patients was 58.94 ± 14.8 years. Of these patients, 288 (172 female, 116 male) underwent only upper gastroin­testinal endoscopy, 116 (61 female, 55 male) underwent only colonoscopy and 84 (39 male, 45 female) under­went both upper gastrointestinal endoscopy and colonos­copy. The rates of failure to reveal the cause of IDA in patients in whom either upper gastrointestinal endoscopy or colonoscopy had been performed were 18.75% and 46.55%, respectively. On other hand, the ratio of failure to reveal the cause of IDA was 3.48% in patients in whom both upper gastrointestinal endoscopy and colonoscopy had been performed. Conclusion: When referring any patient with iron defi­ciency anemia to endoscopy unit, ordering both upper gastrointestinal endoscopy and colonoscopy may allow us to find the reason more accurately.

Keywords

Iron deficiency anemia, gastrointestinal en­doscopy, gastrointestinal system

Demir eksikliği anemili hastalarda gastrointestinal endoskopik inceleme sonuçları

Abstract

Amaç: Endoskopi ünitelerinde, demir eksikliği anemisi nedenini saptamaya yönelik işlemler yapılmaktadır. De­mir eksikliği anemisi (DEA) ön tanısıyla yapılan endosko­pik incelemelerin sonuçları retrospektif olarak taranarak, sonuçların paylaşılması amaçlandı. Gereç ve yöntem: Haydarpaşa Numune Eğitim ve Araş­tırma Hastanesi Gastroenteroloji Endoskopi ünitesi 2008-2010 yılları arasındaki endoskopi kayıtları retrospektif olarak tarandı. Demir eksikliği anemisi endikasyonu ne­deniyle endoskopi yapılan hastalar belirlendi. Hastaların bulguları kaydedilerek analiz edildi. Bulgular: Hastanemiz endoskopi ünitesinde anemi nede­ni ile işlem yapılan toplam 490 hasta değerlendirildi. Has­talarımızın yaş ortalaması: 58.94 ± 14.8 yıl idi. Toplam 288 hastaya (172 kadın,116 erkek) sadece gastroskopi, 116 hastaya (61 kadın, 55 erkek) ise sadece kolonoskopi yapılmıştı. Gastroskopi ve kolonoskopinin birlikte yapıldı­ğı hasta sayısı ise 84 (39 erkek, 45 kadın) idi. Tek işlem yapılan hastalarda DEA nedeni olabilecek patolojiye rast­lamama oranı gastroskopide %18.75, kolonoskopide ise %46.55 ile kolonoskopide daha yüksek olarak bulundu (p

Keywords

Demir eksikliği anemisi, gastrointes­tinal endoskopi, gastrointestinal sistem

References

• McIntyre AS, Long RG. Prospective survey of investigations in outpatients referred with iron deficiency anemia. Gut 1993;34(8):1102-7.
• Provan D. Mechanism and management of iron deficiency anemia. Br J Haematol 1999;105(Suppl 1):19-26.
• Kepczyk T, Kadakia SC. Prospective evaluation of gastroin- testinal tract in patients with iron-deficiency anemia. Dig Dis Sci 1995; 40(6):1283-9.
• Hardwick RH, Armstrong CP. Synchronous upper and lower gastrointestinal endoscopy is an effective meth- od of investigating iron-deficiency anemia. Br J Surg 1997;84(12):1725-8.
• Looker AC, Dalman PR, Carroll MD et al. Prevalance of iron deficiency anemia in United States. JAMA 1997;277(12): 973-6.
• Shaw AG, Simpson J, Tierney G et al. Referral of patients with iron deficiency under the lower gastrointestinal two- week wait rule. Colorectal Dis 2008; 10(3): 294-7.
• Brady PG. Iron deficiency anemia: A call for aggresive diag- nostic evaluation. Southern Medical J 2007;100(7):966-7.
• Erdem Ö, Bucaktepe GE, Kara İH. Aile hekimligi poliklini- ğine basvuran kadınlarda demir eksikliği anemisi ve gestas- yon öyküsü ilişkisi. Dicle Tıp Dergisi 2009; 36(2):123-6.
• Capruso G, Baccini F, Osborn J et al. Can patient at charac- teristics predict the outcome of endoscopic evaluation of iron deficiency anemia:a multiple logistic regression analy- sis. Gastrointest Endosc 2004;59(5):766-71.
• American Gastroenterological Association medical po- sition statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 2000;118(2):197-201.
• Appropriate use of gastrointestinal endoscopy. A consensus statement from the American Society for Gastrointestinal Endoscopy. Gastrointest Endosc 2000:52(6):831-7.
• Goddard AF, James MW, McIntyre AS, Scott BB on behalf of the BSG. Guidelines for the management of iron defi- ciency anemia. 2005 Available at: http://www.bsg.org.uk/ pdf word-does/iron_def.pdf
• Serefhanoglu S, Buyukasik Y, Emmungil H et al. Identifica- tion of clinical and simple laboratory variables predicting responsible gastrointestinal lesions in patients with iron de- ficiency anemia. Int J Med Sci 2010;28(1):30-8.
• Kurtoğlu E, Kayaçetin E, Uğur A. Demir Eksikliği Ane- misi Saptanan Erkeklerde ve Postmenapozal Kadınlardaki Alt ve Üst Gastrointestinal Sistem Bulguları. MN Klinik Bilimler & Doktor 2004;10(3):251-4
• Malfertheiner P, Megraud F, O’Morain C et al. Current con- cepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 2007;56(6):772- 81.
• Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron de- ficiency and Helicobacter pylori infection in the United States. Am J Epidemiol. 2006;163(1):127-34.