1. COLONOSCOPIC FINDINGS IN PATIENTS WITH IRON DEFICIENCY ANEMIA AND NEGATIVE GASTROSCOPY I. Familas, G. Ntetskas, I. Strigklogianis, V. Papastergiou, E. Anastasiou, M. Stampori, E. Asonitis, F. Lambrianou, K. Roufas, I. Karagiorgi, S. Karatapanis Gastroenterology and 1 st Department of Internal Medicine, General Hospital of Rhodes, Rhodes, Greece

2. INTRODUCTION Patients with iron deficiency anemia consist a common clinical problem These patients have to undergo complete endoscopic evaluation of the upper and lower GI tract. Upper GI endoscopy usually precedes endoscopic evaluation of the colon.

3. AIM OF STUDY To analyze the colonoscopic findings of patients with iron deficiency anemia who had a prior upper GI endoscopy with negative findings.

4. PATIENTS AND METHODS (1) In this study were included 34 consecutive patients (M/F=15/19, mean age 52) who underwent endoscopic evaluation with colonoscopy to investigate iron deficiency anemia during the last 18 months. All patients had a prior upper GI endoscopy without findings to explain the cause of anemia.

5. PATIENTS AND METHODS (2) All patients had a complete laboratory investigation to confirm iron deficiency anemia From the study were excluded patients with cirrhosis, patients with malignancy, patients with gastrectomy and patients with a recent history of GI bleeding

6. PATIENTS AND METHODS (3) The severity of anemia was graded as follows : Severe : Hb ≤ 8gr Moderate : 8gr ≤ Hb ≤10 gr Mild : Hb ≥ 10gr

7. RESULTS (1) The severity of anemia was high in 5 patients, moderate in 6 and mild in the remaining 21 patients. On colonoscopy the following findings were found : colon cancer in 5 (14.7%), vascular ectasias in 2 cases, colitis in 2 ( 1 atypic, 1 ischemic), polyps in 4 cases, single ulcer of the rectum in 1 In 18 patients (53%) no findings were seen.

8. RESULTS (2) COLONOSCOPIC FINDINGS COLON CANCER5 (14.7%) POLYPS4 (11.8%) COLITIS2 (5.9%) VASCULAR ECTASIAS2 (5.9%) SINGLE RECTAL ULCER1 (2.9%) NO FINDINGS18 (52.9%)

9. CONCLUSIONS In patients with iron deficiency anemia and negative upper GI endoscopy the endoscopic evaluation of the colon remains negative in the majority of the cases. However in a significant proportion of patients colon cancer is detected.