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Download Investigation of Iron Deficiency Anaemia (IDA) – who should be
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HealthEast CIC Quick Pages www.healtheastcic.co.uk/quickpages Investigation of Iron Deficiency Anaemia (IDA) –who should be referred? 1. Is this patient iron deficient and anaemic? Microcytic anaemia can be caused by IDA, anaemia of chronic disease, haemoglobinopathy. Therefore IDA needs to be confirmed by a low ferritin / transferrin saturation*. Iron deficiency without anaemia does not need investigation unless the patient is >50yo male or post menopausal female *For patients with known inflammatory disease, eg rheumatoid arthritis, or liver disease, ferritin may be inappropriately raised. A low transferrin would indicate IDA in these patients. 2. Does the patient need GI investigation? All patients with IDA should have serological screen for coeliac disease (and urine dipstick) Patients >50yo, or with marked anaemia, or with significant family history of colorectal cancer*, lower GI investigation should be considered even if coeliac disease is found. GI investigations should be considered for males of any age and postmenopausal females unless there is a history of overt non-GI blood loss Premenopausal women should only be considered for GI investigation if they are >50yo, or have GI symptoms, or have a significant family history of colorectal cancer*. *2 first degree relatives, or 1 first degree relative <50yo affected 3. How should the patient be referred? IDA and dyspepsia – 2 week wait suspected upper GI cancer IDA and rectal bleeding / change in bowel habit - 2 week wait suspected lower GI cancer IDA, no other symptoms, male, and Hb <11g/dl - 2 week wait suspected lower GI cancer IDA, no other symptoms, postmenopausal female, and Hb <10g/dl - 2 week wait suspected lower GI cancer All others – Choose and Book Author Dr Matthew Williams Email [email protected] Source British Society of Gastroenterology Guideline http://www.bsg.org.uk/images/stories/docs/clinical/guidelines/sbn/iron_def_2011.pdf NICE Clinical guideline 27 http://www.nice.org.uk/nicemedia/pdf/cg027niceguideline.pdf Date September 2011 Health East accepts no responsibility for errors or omissions in Quick Pages. Quick Pages are not clinical tools. Their use cannot replace clinical judgement. Viewing and using Quick Pages will be taken as your acceptance of this
