DIAGNOSTIC YIELD OF BI-DIRECTIONAL ENDOSCOPY IN THE EVALUATION OF PATIENTS WITH IRON DEFICIENCY ANEMIA VISITING THE KURDISTAN CENTER FOR GASTROENTEROLOGY AND HEPATOLOGY (KCGH)

Abstract

Background  Iron Deficiency Anemia (IDA) is the most common cause of anemia worldwide. IDA occurs in 2-5% of adult men and postmenopausal women in the developed world and is a common reason for gastroenterology referral. Bi-directional endoscopy is required to identify the cause of iron deficiency anemia. Objectives  To assess different upper and lower gastrointestinal causes of IDA in patients who attend Kurdistan Centre for Gastroenterology and Hepatology diagnosed with iron deficiency anemia and referred for endoscopy. Patients and Methods It is a cross-sectional study implemented in the Kurdistan centre of Gastroenterology and Hepatology (KCGH) in Sulaimani City, Kurdistan region-Iraq for one year from 1st October 2020 to 30th September 2021 on a sample of one hundred and seventy patients with iron deficiency anemia. The diagnosis and severity classification of iron deficiency anemia was done according to the World Health Organization definition and classification. The gastrointestinal Specialist in the centre implemented the bi-directional endoscopy. Results The diagnostic yield of esophagogastroduodenoscopy findings of iron deficiency anemia patients 51.8% were gastropathy (41%), gastroesophageal reflux disease (32%), gastric ulcer (6%), duodenal ulcer (4%), hiatus hernia (4%), celiac sprue (4%), gastric antral vascular ectasia (3%), tumour (3%) and others (3%). While the diagnostic yield of colonoscopy findings of iron deficiency anemia patients, 43.5% were haemorrhoids (42%), polyps (37%), ulcers (12%), colorectal tumour (5%), and diverticulosis (5%).   Conclusion Bi-directional endoscopy is safe in diagnosing and evaluating patients with iron deficiency anemia with high diagnostic yields.