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  • Title: Barium enema or colonoscopy for the investigation of iron deficiency anaemia?
    Author: Sayer JM, Donnelly MT, McIntyre AS, Barton JR, Grundman MJ, Vicary FR, Long RG.
    Journal: J R Coll Physicians Lond; 1999; 33(6):543-8. PubMed ID: 10633332.
    Abstract:
    OBJECTIVE: To determine whether double contrast barium enema is adequate for excluding carcinoma of the colon in patients with iron deficiency anaemia. DESIGN: Prospective audit. SUBJECTS: One hundred and twenty-three patients with iron deficiency anaemia. INTERVENTION: All patients had upper intestinal (GI) endoscopy, duodenal biopsy and double contrast barium enema. Malignant disease and other GI pathology were treated. Patients with recurrent or persistent anaemia at follow-up were colonoscoped. OUTCOME MEASURE: Colon cancer missed on barium enema examination but detected on colonoscopic examination. RESULTS: An identified GI lesion contributing to their anaemia and 11 colon cancers were found in 71% of patients, all identified on barium enema. Two pre-cancerous conditions were missed on barium enema examination. Only 45% colonoscopies inspected the caecum. CONCLUSION: Double contrast barium enema with sigmoidoscopy is probably sufficient for excluding carcinoma of the colon in iron deficiency anaemia.
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