title: Iron deficiency anemia in patients without gastrointestinal symptoms--a prospective study.
abstract: OBJECTIVE
  Chronic gastrointestinal (GI) bleeding is the leading cause of iron deficiency anaemia (IDA) in men older than 50 years and post-menopausal women. There is a scarcity of data regarding IDA patients without GI symptoms or signs. We conducted a prospective study to determine the prevalence and the locations of the GI tract lesions in patients with asymptomatic IDA.
  
  
  METHODS
  Forty-eight patients with asymptomatic IDA (25 men older than 50 years and 23 post-menopausal women) underwent colonoscopy, gastroscopy and abdominal computed tomography (CT) with contrast agent.
  
  
  RESULTS
  An anaemia-causing lesion was found in 14 (29%) and 16 (33%) patients in the upper and the lower GI tract, respectively. The prevalence of dual lesions (in both the upper and lower GI tract) was low (6%). In 14 (29%) patients, a malignancy, predominantly right-sided colon carcinoma, was responsible for the IDA. Only one patient had a lesion in the small bowel. In 14 (29%) patients, the work-up was negative.
  
  
  CONCLUSIONS
  Our prospective study demonstrates a high rate of malignancy, predominantly right-sided colon carcinoma, in men older than 50 years and post-menopausal women with asymptomatic IDA. This finding obligates a complete and rigorous GI tract examination in this group of patients, especially of the right colon.
authors.affiliation: Department of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Eva
authors.initials: E
authors.lastname: Niv
authors.forename: Avishay
authors.initials: A
authors.lastname: Elis
authors.forename: Rivka
authors.initials: R
authors.lastname: Zissin
authors.forename: Timna
authors.initials: T
authors.lastname: Naftali
authors.forename: Ben
authors.initials: B
authors.lastname: Novis
authors.forename: Michael
authors.initials: M
authors.lastname: Lishner
mesh_terms: D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis / Q000209:etiology*; D003110:Colonic Neoplasms / Q000150:complications* / Q000453:epidemiology; D003113:Colonoscopy; D005260:Female; D005756:Gastritis / Q000150:complications* / Q000453:epidemiology; D005773:Gastroscopy; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D011446:Prospective Studies