QJM Advance Access originally published online on January 20, 2007
QJM 2007 100(2):143-144; doi:10.1093/qjmed/hcl143
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Colonoscopy first for iron-deficiency anaemia
Sir,I read the article ‘Colonoscopy first for iron-deficiency anaemia' with interest.1 Surgeons doing endoscopic investigations for iron-deficiency anaemia often seem to have a blind spot when it comes to diagnosing coeliac disease, a very common cause of iron deficiency. Endoscopic small bowel biopsy should be done routinely in all cases, as recommended by the BSG guidelines, yet this is often not done.
The fact that apparently no case of coeliac disease was diagnosed in a series of 2318 patients, and that coeliac disease is not even mentioned in this paper, suggests that small bowel biopsies were often not done, and consequently many of their patients who had coeliac disease are continuing to suffer with chronic ill-health, due to the lack of a proper diagnosis.
Judging by our figures in Bristol, in a series of 2318 patients with iron deficiency, about 200 might be expected to have coeliac disease. I hope that the authors can confirm that some at least were diagnosed and given appropriate management.
Frenchay Hospital
Bristol
email: richard.harvey1{at}virgin.net
References
1. Stephens MR, Hopper AN, White SR, et al. (2006) Colonoscopy first for iron-deficiency anaemia: a Numbers Needed to Investigate approach. Q J Med 99 389–95.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||