Role of Upper and Lower Gastrointestinal Endoscopy in Investigating the Etiologies of Iron Deficiency Anemia in Postmenopausal Women

Iron deficiency anemia has been considered as an alarming sign of the possible presence of malignancy in the digestive tract. Inadequate assessment of such affected patients can lead to delay in the diagnosis of gastrointestinal (GI) tumors especially colorectal cancers. Therefore the present study examined the upper and lower GI tract of postmenopausal women with iron deficiency anemia by GI endoscopy.
Women aged over 45 years referred to Gastroenterology Clinic of Imam Khomeini Hospital were asked about their menstruation. Postmenopausal women with the anemia were enrolled. A list of laboratory studies were performed for all included patients. These laboratory studies included complete blood count (CBC), iron profile and stool examination for occult blood. 103 postmenopausal women with iron deficiency anemia according to laboratory tests were interviewed and their clinical and biochemical variables were recorded. All of the study patients underwent esophagogastroduodenoscopy and colonoscopy. The endoscopic findings were recorded regarding the presence of GI lesions causing iron deficiency anemia or the lack of them.
A total of 103 patients participated in this study. Endoscopy revealed a source of iron deficiency anemia in 90.3% of the study population. Upper and lower GI tract lesions were found in 73.8% and 51.5% of the patients, respectively. The most frequent lesions in the upper GI endoscopy were severe gastroesophageal reflux disease involving 34 patients (33%) followed by gastric erosions in 31 cases (30.1%) and duodenal ulcer in 15 cases (14.6%).
In postmenopausal women with iron deficiency anemia as in men, it is necessary to examine the GI tract.