Gastrointestinal Evaluation of Iron Deficiency Anemia

In patients with anemia, diagnose iron deficiency if:

 • Ferritin < 45

 • Additional laboratory tests may be needed in patients with underlying inflammation or chronic kidney tests

Test for celiac disease with serology first

Small bowel biopsy only if serology is positive

Bidirectional endoscopy:

 • Recommended in men and postmenopausal women

 • Suggested in premenopausal women

Non-invasive testing for H pylori

Do not perform routine gastric biopsies

Capsule endoscopy only if:

 • Negative bidirectional endoscopy

 • Insufficient response to iron supplementation

 • Patient population where identification of small bowel pathology will change medical management



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