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Wendy Winsor, Mark Borgaonkar

Department of Internal Medicine, Memorial University of Newfoundland, St John’s, Newfoundland

BACKGROUND: Iron deficiency anemia is the most common cause of anemia in Canada. It occurs in 2-5% of adult men and post-menopausal woman and 5-10% of menstruating women in the developed world. It is suggested that patients with iron deficiency anemia and no obvious cause should have both upper gastrointestinal endoscopy, with small bowel biopsy and either a colonoscopy or barium enema. The purpose of this study is to identify the causes of iron deficiency in patients referred for a gastrointestinal assessment. We propose that frequent blood donation is a significant cause of iron deficiency anemia that is often under recognized and if identified early may prevent unnecessary investigations.

METHODS: A chart review was conducted on patients referred to a gastroenterologist in a tertiary care center in St. John’s NL, for work up of iron deficiency anemia between July 2000 and May 2003.

RESULTS: There were a total of 130 patients with iron deficiency anemia in this study. Patient age ranged between 16-90 years and the average age was 59 years. Twelve (9.2%) patients were found to be iron deficient due to frequent blood donation, after a thorough history and gastrointestinal work-up. Another significant cause of iron deficiency anemia in this study is colon cancer. Thirteen patients (10%) were diagnosed with colon cancer, these patients were found on average to be older and have lower hemoglobin than the other participants in this study.

CONCLUSION: Frequent blood donation was a significant cause of iron deficiency in patients in this study. A history of frequent blood donation should be considered in patients presenting with iron deficiency anemia. It may prevent an unnecessary gastrointestinal workup in select patients who are younger and have less risk factors for serious illnesses such as colon cancer.

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