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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To assess the indications and yield of single session panendoscopy (SSPE), patients who underwent colonoscopy and esophagogastroduodenoscopy (EGD) at the same time were retrospectively reviewed. Endoscopy records and patient charts of 101 patients who underwent SSPE during a 45-month period were analyzed for demography, indication, and results. Average age was 72.9 years. Common indications were positive occult blood tests (74%), anemia (28%), altered bowel habits (15%), and iron deficiency (13%). Most frequent findings at colonoscopy included diverticulosis (47%), polyps (37%), hemorrhoids (28%), and arteriovenous (AV) malformations (13%). Nine cases of cancer were found, seven of which were right-sided. Colonoscopy was normal in 12 per cent. EGD findings include esophagitis (55%), hiatal hernia (47%), and gastritis (33%). Eleven per cent were normal. Occult blood loss is not predictive of either a positive or negative study. SSPE is a safe and specific approach; however, based on this study, colonoscopy is recommended as the initial study for occult blood loss with plans to proceed to EGD when the lower endoscopy is normal. Even when the colonoscopy suggests the etiology for occult blood loss, EGD will yield a significant number of treatable and unsuspected lesions.
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PMID:Single session panendoscopy. Indications and expectations for yield. 210 79

In a retrospective analysis of open-access versus hospital-referred flexible sigmoidoscopies, the two groups are compared with reference to the demographic data, presenting symptoms, sigmoidoscopy findings and diagnostic yield. Overall, 1090 patients underwent sigmoidoscopy during 12 months, 544 in the open-access and 546 in the hospital-referred group. There was a preponderance of females in both groups, but patients in the hospital-referred group were older. Diarrhoea was the most common presenting symptom, followed by rectal bleeding. Significantly more patients presented with rectal bleeding with or without diarrhoea and abdominal pain in the open-access group, while there were more patients with iron deficiency in the hospital-referred group. The number of patients with colonic carcinoma was similar in the two groups, but significantly more early carcinomas were found in the open-access group. There were significantly more patients with haemorrhoids in the open-access group. The positivity rate was similar in the two groups (52% in the open-access vs 46% in the hospital-referred group). Of the 24% of patients 40 years or under, none had carcinomas. In this age range the positivity rate was no different in the two groups (32% in the open-access vs 23% in the hospital-referred group). The diagnostic yield of open-access flexible sigmoidoscopy is thus comparable to hospital-referred sigmoidoscopy, suggesting that it should be freely available to GPs.
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PMID:Sigmoidoscopy service in a district general hospital: open-access versus hospital-referred. 774 79

In Europe, iron deficiency is considered to be one of the main nutritional deficiency disorders affecting large fractions of the population, particularly such physiological groups as children, menstruating women and pregnant women. Some factors such as type of contraception in women, blood donation or minor pathological blood loss (haemorrhoids, gynaecological bleeding...) considerably increase the difficulty of covering iron needs. Moreover, women, especially adolescents consuming low-energy diets, vegetarians and vegans are at high risk of iron deficiency. Although there is no evidence that an absence of iron stores has any adverse consequences, it does indicate that iron nutrition is borderline, since any further reduction in body iron is associated with a decrease in the level of functional compounds such as haemoglobin. The prevalence of iron-deficient anaemia has slightly decreased in infants and menstruating women. Some positive factors may have contributed to reducing the prevalence of iron-deficiency anaemia in some groups of population: the use of iron-fortified formulas and iron-fortified cereals; the use of oral contraceptives and increased enrichment of iron in several countries; and the use of iron supplements during pregnancy in some European countries. It is possible to prevent and control iron deficiency by counseling individuals and families about sound iron nutrition during infancy and beyond, and about iron supplementation during pregnancy, by screening persons on the basis of their risk for iron deficiency, and by treating and following up persons with presumptive iron deficiency. This may help to reduce manifestations of iron deficiency and thus improve public health. Evidence linking iron status with risk of cardiovascular disease or cancer is unconvincing and does not justify changes in food fortification or medical practice, particularly because the benefits of assuring adequate iron intake during growth and development are well established. But stronger evidence is needed before rejecting the hypothesis that greater iron stores increase the incidence of CVD or cancer. At present, currently available data do not support radical changes in dietary recommendations. They include all means for increasing the content of dietary factors enhancing iron absorption or reducing the content of factors inhibiting iron absorption. Increased knowledge and increased information about factors may be important tools in the prevention of iron deficiency in Europe.
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PMID:Iron deficiency in Europe. 1168 48

A 38-year-old alcoholic man with severe iron deficient anaemia, and bloody-mucous stool was found to have haemorrhoidal bleeding. In spite of intravenous iron supplements haemoglobin levels were falling. He was admitted because of deteriorating condition, jaundice, severe anaemia (haemoglobin, 38 g/l) and iron deficiency. Except of toxic (alcohol) agent all other causes of liver disease could be excluded. Sclero-, and medical therapy, and abstinence resulted in a rapid improvement in his condition and subsequently rectal bleeding also disappeared. Bleeding from the upper gastrointestinal tract is a well known and serious complication in liver cirrhosis, however, a voluminous blood loss resulting in a life-threatening anaemia from lower gastrointestinal tract or haemorrhoids, as it was detected in this patient, is quite rare. Sclerotherapy seems to be an effective method with only minor complications when compared with other invasive techniques. However, the patient's compliance even in liver cirrhosis with haemorrhoidal nodes is essential for long-term success.
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PMID:[Severe anemia caused by haemorrhoids: the casae of a young man with toxic cirrhosis]. 2346 79