Endoscopic findings in the older patients with iron-deficiency anemia

Aim: The presence of iron-deficiency anemia, which is an important indication for endoscopic procedures, in the geriatric population necessitates the exclusion of a possible malignancy in the gastrointestinal system. This study aims to examine endoscopic findings in geriatric patients that underwent esophagogastroduodenoscopy and colonoscopy because of iron-deficiency anemia. Materials and Methods: Sixty patients aged 65 and over who underwent esophagogastroduodenoscopy and colonoscopy because of iron-deficiency anemia between August 2019 and August 2020 were retrospectively evaluated. Age, sex, geriatric age groups of patients, presence of Helicobacter pylori in gastric biopsy, esophagogastroduodenoscopy findings, colonoscopy findings, presence of internal and / or external hemorrhoids, and duodenal biopsy results were examined. Results: Thirty (50%) of 60 patients included in the study were male and the mean age was 72.47 ± 6.07 years. Of these patients, 41 (68.4%) were young-old, 17 (28.3%) were middle-old and 2 (3.3%) were old-old. The most common causes that might explain iron-deficiency anemia in esophagogastroduodenoscopy were atrophic gastritis (21.2%), Helicobacter pylori-positive gastritis (20%), gastric polyp (11.7%), and gastric cancer (3.3%), whereas colonoscopy results were found colon polyps in 23.3% of patients, diverticulum in 15% and angiodysplasia in 15%, and colon cancer in 8.3%. Internal hemorrhoids were also observed in 44 (73.3%) patients. Conclusion: In the older population, blood loss from the gastrointestinal system is the most important cause of iron-deficiency anemia and just hemorrhoids cannot explain IDA. While examining the etiology of patients diagnosed with iron-deficiency anemia, performing both esophagogastroduodenoscopy and colonoscopy is an accurate approach to reach the underlying cause and not to miss a possible malignancy