Is it worth doing barium enemas on patients with unexplained iron deficiency anaemia?

The incidence on double contrast barium enema (DCBE) of carcinomas and polyps > 1 cm in size was compared in 92 patients with iron deficiency anaemia and a group of randomly obtained non-anaemic controls. In the anaemic group there were eight carcinomas and four polyps, and in the control group two carcinomas and no polyps. The incidence of neoplasms in the anaemic group (13.0%) was significantly greater than in the control group (1.6%). The incidence of neoplasms in iron-deficient males was 19% compared with 9% in females. The presence of bowel symptoms or weight loss were not found to be significant. This study confirms the value of DCBE in investigating patients with unexplained iron deficiency anaemia even in the absence of bowel symptoms.