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Endoscopic evaluation of the upper gastrointestinal tract is worthwhile in premenopausal women with iron-deficiency anaemia irrespective of menstrual flow.
Scand J Gastroenterol. 2003 Mar; 38(3):239-45.SJ

Abstract

BACKGROUND

In premenopausal women, iron-deficiency anaemia is common and menstrual flow is often held responsible, but it is not clear whether these women should be submitted to gastrointestinal (GI) evaluation. We aim to prospectively investigate whether premenopausal women with iron-deficiency anaemia benefit from GI evaluation regardless of menstrual flow.

METHODS

The study population comprised 59 consecutive premenopausal women with iron-deficiency anaemia. Excluded were women with obvious or suspected causes of anaemia and those < or = 21 years. Heavy menstrual loss was not considered an exclusion criterion. All subjects had: complete blood count, ferritin, non-invasive testing by faecal occult blood (FOB), 13C-urea breath test (13C-UBT), anti-tissue transglutaminase antibodies (tTG) and gastrin levels. Gastroscopy with antral (n = 3), corporal (n = 3) and duodenal (n = 2) biopsies was performed in women with positive 13C-UBT or tTG titre or hypergastrinaemia.

RESULTS

Heavy menstrual loss was present in 50.8%. Non-invasive tests were positive in 40/59 (67.8%): 30 had positive 13C-UBT, 12 had hypergastrinaemia, 7 had positive tTG and 3 had positive FOB. Women tested positive were similar to those tested negative as far as concerned age, haemoglobin and ferritin levels and heavy menstrual flow (55% versus 42.1%). All 40 women tested positive underwent gastroscopy with biopsies. Four (10%) had bleeding-associated lesions and 34 (85%) had non-bleeding-associated lesions. As regards upper GI findings, no differences were observed between women with normal and those with heavy menstrual flow. No lower GI tract lesions were detected in the three women with positive FOB.

CONCLUSIONS

Our data suggest that premenopausal women with iron-deficiency anaemia benefit from endoscopic evaluation of the upper GI tract irrespective of menstrual flow.

Authors+Show Affiliations

Digestive and Liver Disease Unit, 2nd Medical School, Policlinico Universitario Ospedale Sant' Andrea, Dept. of Haematology, University La Sapienza, Rome, Italy. bruno.annibale@uniroma1.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12737437

Citation

Annibale, B, et al. "Endoscopic Evaluation of the Upper Gastrointestinal Tract Is Worthwhile in Premenopausal Women With Iron-deficiency Anaemia Irrespective of Menstrual Flow." Scandinavian Journal of Gastroenterology, vol. 38, no. 3, 2003, pp. 239-45.
Annibale B, Lahner E, Chistolini A, et al. Endoscopic evaluation of the upper gastrointestinal tract is worthwhile in premenopausal women with iron-deficiency anaemia irrespective of menstrual flow. Scand J Gastroenterol. 2003;38(3):239-45.
Annibale, B., Lahner, E., Chistolini, A., Gailucci, C., Di Giulio, E., Capurso, G., Luana, O., Monarca, B., & Delle Fave, G. (2003). Endoscopic evaluation of the upper gastrointestinal tract is worthwhile in premenopausal women with iron-deficiency anaemia irrespective of menstrual flow. Scandinavian Journal of Gastroenterology, 38(3), 239-45.
Annibale B, et al. Endoscopic Evaluation of the Upper Gastrointestinal Tract Is Worthwhile in Premenopausal Women With Iron-deficiency Anaemia Irrespective of Menstrual Flow. Scand J Gastroenterol. 2003;38(3):239-45. PubMed PMID: 12737437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic evaluation of the upper gastrointestinal tract is worthwhile in premenopausal women with iron-deficiency anaemia irrespective of menstrual flow. AU - Annibale,B, AU - Lahner,E, AU - Chistolini,A, AU - Gailucci,C, AU - Di Giulio,E, AU - Capurso,G, AU - Luana,O, AU - Monarca,B, AU - Delle Fave,G, PY - 2003/5/10/pubmed PY - 2003/10/29/medline PY - 2003/5/10/entrez SP - 239 EP - 45 JF - Scandinavian journal of gastroenterology JO - Scand J Gastroenterol VL - 38 IS - 3 N2 - BACKGROUND: In premenopausal women, iron-deficiency anaemia is common and menstrual flow is often held responsible, but it is not clear whether these women should be submitted to gastrointestinal (GI) evaluation. We aim to prospectively investigate whether premenopausal women with iron-deficiency anaemia benefit from GI evaluation regardless of menstrual flow. METHODS: The study population comprised 59 consecutive premenopausal women with iron-deficiency anaemia. Excluded were women with obvious or suspected causes of anaemia and those < or = 21 years. Heavy menstrual loss was not considered an exclusion criterion. All subjects had: complete blood count, ferritin, non-invasive testing by faecal occult blood (FOB), 13C-urea breath test (13C-UBT), anti-tissue transglutaminase antibodies (tTG) and gastrin levels. Gastroscopy with antral (n = 3), corporal (n = 3) and duodenal (n = 2) biopsies was performed in women with positive 13C-UBT or tTG titre or hypergastrinaemia. RESULTS: Heavy menstrual loss was present in 50.8%. Non-invasive tests were positive in 40/59 (67.8%): 30 had positive 13C-UBT, 12 had hypergastrinaemia, 7 had positive tTG and 3 had positive FOB. Women tested positive were similar to those tested negative as far as concerned age, haemoglobin and ferritin levels and heavy menstrual flow (55% versus 42.1%). All 40 women tested positive underwent gastroscopy with biopsies. Four (10%) had bleeding-associated lesions and 34 (85%) had non-bleeding-associated lesions. As regards upper GI findings, no differences were observed between women with normal and those with heavy menstrual flow. No lower GI tract lesions were detected in the three women with positive FOB. CONCLUSIONS: Our data suggest that premenopausal women with iron-deficiency anaemia benefit from endoscopic evaluation of the upper GI tract irrespective of menstrual flow. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/12737437/Endoscopic_evaluation_of_the_upper_gastrointestinal_tract_is_worthwhile_in_premenopausal_women_with_iron_deficiency_anaemia_irrespective_of_menstrual_flow_ L2 - https://medlineplus.gov/menstruation.html DB - PRIME DP - Unbound Medicine ER -