Work

Association Between Iron-Deficiency Anemia and Endoscopic Findings in Patients Undergoing Upper Gastrointestinal (GI) Endoscopy

Year: 2026

Type: article

Abstract: BACKGROUND: Iron-deficiency anemia (IDA) may be associated with underlying gastrointestinal pathology. This study examined the association between IDA and upper gastrointestinal endoscopic findings and described the range of endoscopic abnormalities in patients with IDA. METHODS: A prospective observational cross-sectional study involving 570 adults who underwent upper gastrointestinal endoscopy. We collected biological, clinical, demographic, hematological, and iron-profile data. We defined IDA as anemia according to sex-specific hemoglobin thresholds accompanied by a serum ferritin concentration of <15 ng/mL. We categorized participants as having IDA or no IDA and compared endoscopic findings between groups. We used multivariable logistic regression to identify independent factors for an abnormal endoscopy. RESULTS: IDA was found in 259 (45.4%) participants, and abnormal upper gastrointestinal endoscopy was detected in 376 (66.0%). Abnormal findings were more frequent among participants with IDA (211 (81.5%)) than those without IDA (165 (53.1%); OR: 3.89; 95% CI: 2.65-5.71; p < 0.001). After adjustment, IDA was independently associated with abnormal endoscopy (adjusted OR: 3.875; 95% CI: 2.617-5.738; p < 0.001). After adjustment, IDA remained independently associated with esophagitis (aOR: 2.46; 95% CI: 1.43-4.22), gastritis (aOR: 1.91; 95% CI: 1.30-2.80), gastric ulcer (aOR: 2.69; 95% CI: 1.53-4.72), and duodenal ulcer (aOR: 2.71; 95% CI: 1.36-5.40). Nonsteroidal anti-inflammatory drug (NSAID) use was independently associated with abnormal endoscopy (adjusted OR: 1.766; 95% CI: 1.078-2.894; p = 0.024). CONCLUSIONS: IDA was strongly associated with abnormal endoscopic findings in the upper gastrointestinal tract, especially inflammatory and ulcerative lesions. These findings support the clinical relevance of upper gastrointestinal evaluation among appropriately selected patients with IDA.

Source: Cureus

DOI: 10.7759/cureus.117713