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.