Table 4

Sample guidelines for investigation of iron deficiency anaemia

Programme A: for all patients
Patients 45–74 with recently diagnosed anaemia• Colonoscopy. If no major lesion perform
• Upper GI endoscopy/duodenal biopsy at same session
Patients <45, >75 with recently diagnosed anaemia• Upper GI endoscopy. If no major lesion include
    and • Duodenal biopsy. Also perform
All patients with chronic anaemia• Colonoscopy at same session in patients >45
Colonoscopy incomplete• Barium enema
Programme B: for patients still undiagnosed
All patients• Stop iron supplements
To complete investigation select from• Full dietary history by dietitian
• Gynaecological review for women menstruating
• Renal ultrasound scan for patients >50
• Small bowel contrast radiology or enteroscopy
Anaemia recurs in absence of diagnosis• Regular follow up. Consider repeat or further investigation

  • GI=gastrointestinal.