title: Upper and lower gastrointestinal causes of iron deficiency anemia in elderly compared with adult outpatients.
abstract: OBJECTIVE
  In the elderly, prevalence of bleeding- and/or iron malabsorption-related gastrointestinal (GI) causes of iron deficiency anemia (IDA) has not been addressed yet. The aim of this study was to assess the occurrence of malabsorptive diseases and bleeding lesions of the upper and lower GI tract in early (65-74 year-old) and late (over 75 year-old) elderly group compared with adult (50-64 year-old) outpatients.
  
  
  METHODS
  The study enrolled 136 consecutive adult (N.=31), early (N.=48) and late elderly (N.=57) IDA outpatients who were referred to the Gastroenterology Department for IDA evaluation and underwent gastroscopy/histology and colonoscopy.
  
  
  RESULTS
  Bleeding lesions were significantly less frequent in adult patients than in elderly patients (29% vs. 49.5%, P=0.0252). The most common bleeding lesions were large hiatal hernia (14.7%) and colon cancer (12.5%). Iron malabsorption diseases (Hp-related pangastritis, atrophic body gastritis and celiac disease) were more frequent in the adult group than in the early elderly group (80.6% vs. 56.2%, P=0.0367). In elderly patients, the observed prevalence of bleeding and iron malabsorption IDA causes was similar, whereas in adult patients iron malabsoptive diseases were more frequently detected (P<0.0001). The occurrence of concomitant IDA causes was not different among the three age-groups.
  
  
  CONCLUSIONS
  In the early and late elderly, almost half of GI IDA causes are related to bleeding lesions which are more frequently observed respect to the adult patients. Iron malabsorption diseases affect almost 60% of early and late elderly groups. As for adult patients, an accurate upper and lower endoscopical/histological evaluation diagnoses IDA causes in the vast majority of the elderly outpatients.
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, II School of Medicine, La Sapienza University, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Vannella
authors.forename: M A
authors.initials: MA
authors.lastname: Aloe Spiriti
authors.forename: E
authors.initials: E
authors.lastname: Di Giulio
authors.forename: E
authors.initials: E
authors.lastname: Lahner
authors.forename: V D
authors.initials: VD
authors.lastname: Corleto
authors.forename: B
authors.initials: B
authors.lastname: Monarca
authors.forename: G
authors.initials: G
authors.lastname: Delle Fave
authors.forename: B
authors.initials: B
authors.lastname: Annibale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D041741:Lower Gastrointestinal Tract / Q000473:pathology*; D008286:Malabsorption Syndromes / Q000150:complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D041742:Upper Gastrointestinal Tract / Q000473:pathology*