#IRON DEFICIENCY ANEMIA (IDA)

- ferritin threshold value of <45 ng/mL (sensitivity 85%, specificity of 92%)

-evidence of GI bleeding: melena, BRBPR, hematemesis

-prior endoscopies: ***

-prior AVM's: ***

-fevers, chills, unintentional weight loss

-abdominal pan, NSAIDs

-diarrhea, nocturnal diarrhea, joint pains, rashes, eye redness, bloody stools

-sensitivity to gluten

-history of gastric surgery/resection, RYGB

Recommendations:

-Send celiac disease serologies

-send H. Pylori stool antigen (preferably off PPI >2 weeks)

-send fecal calprotectin (if diarrhea)

-check for Vitamin B12 deficiency

- In asymptomatic postmenopausal women and men with iron-deficiency anemia EGD, colonoscopy is recommended. [In asymptomatic premenopausal women EGD/Colo is a conditional recommendation)

-potential capsule endoscopy if EGD/Colo unrevealing

References:

Ko CW, Siddique SM, Patel A, Harris A, Sultan S, Altayar O, Falck-Ytter Y. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020 Sep;159(3):1085-1094. doi: 10.1053/j.gastro.2020.06.046. Epub 2020 Aug 15. PMID: 32810434.