A prospective study on the role of Bi-directional endoscopy in evaluating young males with Iron Deficiency Anemia
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 1
Abstract
Aim: This study tried to assess the utility of Bi-directional endoscopy in the management algorithm of young adult males with Iron deficiency anemia (IDA). The main objective being, to study the diagnostic yield of upper and lower GI endoscopy in detecting the cause of iron deficiency Material & Methods: The study was a hospital-based prospective observational study, which enrolled consecutive male patients (18-40 yrs) with IDA visiting a Tertiary care center. The study period was from Oct 2015 to Dec 2017. All patients underwent Upper GI endoscopy & Colonoscopy as part of the study protocol along with a standard work up for IDA. Data was collected and analyzed in SPSS version16, and standard descriptive statistics along with Analysis of variance (ANOVA) and Univariate followed by Multivariat analysis with logistic regression was done. The effort was to establish any statistically significant association between the study parameters and the outcome on endoscopies. Results: 50 patients who met the inclusion criteria and gave their consent, were included in the study. Upper GI lesions were diagnosed in 13 men (26 %). Gastritis was the most common lesion (6), followed by Peptic ulcers (4) and Celiac disease (3). Significant lower GI tract lesions were diagnosed in 05 men (10 %). Inflammatory bowel disease was diagnosed in 2 men (2 %), followed by one each of adenomatous polyps , caecal tuberculosis and solitary rectal ulcer. In univariate analysis, Lower hemoglobin levels, Fecal occult blood (FOB) positivity, and any GI symptoms were associated with the diagnosis of a significant GI lesion. In multivariate analysis with logistic regression, the presence of any GI symptoms (p < 0.001, OR 1.44, CI 0.112 – 0.394) and Fecal Occult Blood (FOB) Positivity (p <0.036, CI 0.023 – 0.692) were found to be significantly associated with the diagnosis of clinically significant GI lesions on endoscopy. Conclusion: This study on young males with IDA, shows that similar to other western studies, Indian subjects with IDA also have an increased prevalence of GI lesions, which are detectable on bidirectional endoscopy (18/50). The results of the study suggest that all young men with IDA should be evaluated with endoscopies & specific complaints may dictate the order of evaluation. Celiac serology (IgA TTG) was positive in 6% cases and should be performed routinely in IDA cases even in our patients. In patients with IDA, those with low serum ferritin, positive GI symptoms, and positive fecal occult blood test, are more likely to have potentially correctable GI lesions on endoscopies.
Authors and Affiliations
Col (Dr) R K Anadure
Keywords
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