392 CURRENT MANAGEMENT OF IRON DEFICIENCY ANAEMIA BY GENERAL PHYSICIANS DOES NOT COMPLY WITH BRITISH SOCIETY OF GASTROENTEROLOGY GUIDELINES

H.R. Ferguson, P. Murphy.Department of Gastroenterology, Craigavon Area Hospital, Northern Ireland, UK

Introduction: Iron deficiency anaemia is a common problem encountered in all medical specialties. In men and post menopausal women common causes are gastrointestinal blood loss or malabsorption. The British Society of Gastroenterology (BSG) recently produced guidelines on the management of this condition.

Aim: To establish current practice in the investigation of iron deficiency anaemia.

Methods: The laboratory identified all patients with a haemoglobin and mean cell volume below the normal range, for the six month period between January and July 2001. The charts of those patients under the care of consultant physicians were reviewed. Data collected included details of history taking, examination, investigations performed, treatment and follow up.

Results: 74 patients were identified with both a low haemoglobin and mean cell volume (age range 15–90 years). 70% were female. A rectal examination was performed in 16%. 13 patients (18%) had antiendomysial antibodies tested. 27 patients (36%) had colonoscopy or barium enema performed, planned, or were unsuitable for investigation. 25 (34%) had an OGD or barium meal performed, planned or were unsuitable. One patient had duodenal biopsy. A reason for anaemia was found in 24 patients (32%). In this group five had colonic or gastric carcinoma, and no diagnosis of coeliac disease was made. 38 patients (52%) were placed on iron supplements. Excluding four patients who were unsuitable for follow up, 49 (70%) had a hospital review arranged.

Conclusion: A low proportion of patients underwent full upper and lower GI tract investigation although five patients were diagnosed with carcinoma. No cases of coeliac disease were detected, but only 18% had antiendomysial antibodies tested, and one duodenal biopsy was performed. We have produced a summary of the BSG guidelines to improve management of these patients and encourage early referral …