Gastrointestinal investigations for anaemia in the elderly: a prospective study

Of 60 patients referred for geriatric assessment with clinically significant hypochromic anaemia, in the absence of frank bleeding, 44 underwent upper gastrointestinal and 27 lower gastrointestinal investigations. The probability of identifying a potential cause at upper gastrointestinal endoscopy was three times that at barium enema, and five times that at sigmoidoscopy, and the lesions identified at endoscopy were more likely to need treatment. Of 41 who completed investigation, a cause was found in 36, upper gastrointestinal in 29, colonic in six and ileal in one. Six upper gastrointestinal and three colonic lesions were found in the 11 of these without gastrointestinal symptoms. Upper gastrointestinal endoscopy in elderly patients with unexplained hypochromic anaemia will identify a treatable cause in a high proportion of cases.