Background/aims: A major etiology of iron deficiency anemia (IDA) is chronic blood loss from the gastrointestinal tract or gynecological organs. The impact of small intestinal lesions on IDA is as yet unclear. The aim of the present study was to estimate the incidence of small intestinal lesions in patients with IDA and elucidate the pathogenic nature of small intestinal mucosal abnormalities for IDA.
Methodology: Between January 2007 and October 2008, a total of 30 IDA patients (hemoglobin (Hb) <13.5g/dL for all men and post-menopausal women, Hb <11.0g/dL for pre-menopausal women) without any bleeding sources detected by upper and lower endoscopy were enrolled. All patients underwent CE. The Given Imaging Ltd. database containing 61 healthy volunteers was used as a control. The prevalence of small intestinal lesions was compared.
Results: The prevalence of significant lesions including angioectasias, tumors and erosions was higher in patients with IDA than controls (46% vs. 15%, p<0.01). Multivariate analysis showed that IDA was related to significant lesions in the small intestine (OR: 4.7, 95%CI: 1.1-21.3, p=0.04).
Conclusions: Subjects with iron deficiency anemia after negative work-up on the bleeding source by conventional upper and lower endoscopies should undergo capsule endoscopy.