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Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract.
Z Gastroenterol. 2000 Oct; 38(10):827-31.ZG

Abstract

BACKGROUND

In patients with Iron Deficiency Anemia (IDA) occult gastrointestinal bleeding is generally investigated by bidirectional endoscopy. The aim of our study was to examine the long-term follow-up of patients with IDA where the sources of bleeding couldn't be detected despite close endoscopic and radiologic examination of the GI tract.

METHODS

Based on the endoscopic data base we examined consecutive patients who were referred for gastrointestinal endoscopy due to IDA with a negative endoscopic (upper GI endoscopy and colonoscopy) evaluation. Further diagnostic work up (repeated endoscopy of the upper and lower GI tract by an experienced investigator, small bowel enteroclysis, push enteroscopy, proctoscopy, intraoperative enteroscopy, angiography, scintigraphic examinations) was recorded. The eligible patients were divided into 2 groups: Group 1 (no identification of the source of bleeding in the GI tract); group 2 (source of gastrointestinal blood loss was found). Long-term follow-up was performed by telephone interview with patients and/or with their general practitioner.

RESULTS

79 patients (mean age 58.8 years [17-83, 44] female) with IDA met the inclusion criteria. In 42 patients (53%) the endoscopic and radiographic evaluation was unable to find the source of gastrointestinal blood loss. 29 of these patients (69%) showed a resolved anemia after a mean follow-up of 48 months (18 months-5 years). 10 patients had a mild anemia, 3 required blood transfusions. In group one Helicobacter pylori infection was significantly more prevalent in comparison with group 2 (57% vs. 38%, p = 0.032).

CONCLUSION

Based on our data, the prognosis of IDA with negative endoscopy is favorable. The pathogenic role of Helicobacter pylori infection should be evaluated in further studies.

Authors+Show Affiliations

Department of Internal Medicine C (Gastroenterology and Hepatology), Klinikum der Stadt Ludwigshafen, Academical Teaching Hospital, University of Mainz. MedCLu@t-online.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11089266

Citation

Schilling, D, et al. "Long-term Follow-up of Patients With Iron Deficiency Anemia After a Close Endoscopic Examination of the Upper and Lower Gastrointestinal Tract." Zeitschrift Fur Gastroenterologie, vol. 38, no. 10, 2000, pp. 827-31.
Schilling D, Grieger G, Weidmann E, et al. Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract. Z Gastroenterol. 2000;38(10):827-31.
Schilling, D., Grieger, G., Weidmann, E., Adamek, H. E., Benz, C., & Riemann, J. F. (2000). Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract. Zeitschrift Fur Gastroenterologie, 38(10), 827-31.
Schilling D, et al. Long-term Follow-up of Patients With Iron Deficiency Anemia After a Close Endoscopic Examination of the Upper and Lower Gastrointestinal Tract. Z Gastroenterol. 2000;38(10):827-31. PubMed PMID: 11089266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term follow-up of patients with iron deficiency anemia after a close endoscopic examination of the upper and lower gastrointestinal tract. AU - Schilling,D, AU - Grieger,G, AU - Weidmann,E, AU - Adamek,H E, AU - Benz,C, AU - Riemann,J F, PY - 2000/11/23/pubmed PY - 2001/2/28/medline PY - 2000/11/23/entrez SP - 827 EP - 31 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 38 IS - 10 N2 - BACKGROUND: In patients with Iron Deficiency Anemia (IDA) occult gastrointestinal bleeding is generally investigated by bidirectional endoscopy. The aim of our study was to examine the long-term follow-up of patients with IDA where the sources of bleeding couldn't be detected despite close endoscopic and radiologic examination of the GI tract. METHODS: Based on the endoscopic data base we examined consecutive patients who were referred for gastrointestinal endoscopy due to IDA with a negative endoscopic (upper GI endoscopy and colonoscopy) evaluation. Further diagnostic work up (repeated endoscopy of the upper and lower GI tract by an experienced investigator, small bowel enteroclysis, push enteroscopy, proctoscopy, intraoperative enteroscopy, angiography, scintigraphic examinations) was recorded. The eligible patients were divided into 2 groups: Group 1 (no identification of the source of bleeding in the GI tract); group 2 (source of gastrointestinal blood loss was found). Long-term follow-up was performed by telephone interview with patients and/or with their general practitioner. RESULTS: 79 patients (mean age 58.8 years [17-83, 44] female) with IDA met the inclusion criteria. In 42 patients (53%) the endoscopic and radiographic evaluation was unable to find the source of gastrointestinal blood loss. 29 of these patients (69%) showed a resolved anemia after a mean follow-up of 48 months (18 months-5 years). 10 patients had a mild anemia, 3 required blood transfusions. In group one Helicobacter pylori infection was significantly more prevalent in comparison with group 2 (57% vs. 38%, p = 0.032). CONCLUSION: Based on our data, the prognosis of IDA with negative endoscopy is favorable. The pathogenic role of Helicobacter pylori infection should be evaluated in further studies. SN - 0044-2771 UR - https://www.unboundmedicine.com/medline/citation/11089266/Long_term_follow_up_of_patients_with_iron_deficiency_anemia_after_a_close_endoscopic_examination_of_the_upper_and_lower_gastrointestinal_tract_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2000-9999 DB - PRIME DP - Unbound Medicine ER -