title: Barium enema or colonoscopy for the investigation of iron deficiency anaemia?
abstract: OBJECTIVE
  To determine whether double contrast barium enema is adequate for excluding carcinoma of the colon in patients with iron deficiency anaemia.
  
  
  METHODS
  Prospective audit.
  
  
  METHODS
  One hundred and twenty-three patients with iron deficiency anaemia.
  
  
  METHODS
  All patients had upper intestinal (GI) endoscopy, duodenal biopsy and double contrast barium enema. Malignant disease and other GI pathology were treated. Patients with recurrent or persistent anaemia at follow-up were colonoscoped.
  
  
  METHODS
  Colon cancer missed on barium enema examination but detected on colonoscopic examination.
  
  
  RESULTS
  An identified GI lesion contributing to their anaemia and 11 colon cancers were found in 71% of patients, all identified on barium enema. Two pre-cancerous conditions were missed on barium enema examination. Only 45% colonoscopies inspected the caecum.
  
  
  CONCLUSIONS
  Double contrast barium enema with sigmoidoscopy is probably sufficient for excluding carcinoma of the colon in iron deficiency anaemia.
authors.affiliation: City Hospital, Nottingham.
authors.forename: J M
authors.initials: JM
authors.lastname: Sayer
authors.forename: M T
authors.initials: MT
authors.lastname: Donnelly
authors.forename: A S
authors.initials: AS
authors.lastname: McIntyre
authors.forename: J R
authors.initials: JR
authors.lastname: Barton
authors.forename: M J
authors.initials: MJ
authors.lastname: Grundman
authors.forename: F R
authors.initials: FR
authors.lastname: Vicary
authors.forename: R G
authors.initials: RG
authors.lastname: Long
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D001466:Barium Sulfate; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012812:Sigmoidoscopy
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate