A tweet guide on investigating and managing:

𝗜𝗿𝗼𝗻 𝗱𝗲𝗳𝗶𝗰𝗶𝗲𝗻𝗰𝘆 𝗮𝗻𝗮𝗲𝗺𝗶𝗮 (IDA)

for GPs and non-Gastroenterology colleagues.

Defined as:

Haemoglobin levels
< 110 g/L
< 100 g/L
with MCV / MCH

#GastroTwearls 1/

New anaemia case:

Check haematinics
Don’t forget coeliac screen

Confirm IDA:
ferritin or
transferrin sats or
TIBC & iron 𝘵𝘰𝘨𝘦𝘵𝘩𝘦𝘳

𝘯𝘰𝘵 serum iron alone (can be anaemia of chronic disease)

Correct B12 / folate

#GastroTwearls 2/

When confirmed IDA

Start 𝗢𝗡𝗘 iron tablet daily

Ask if bleeding from:

Nose, refer ENT
Haemoptysis, Resp
Haematuria, Urology

Heavy PV bleeding in menstruating (ask about clots / flooding) or
PV bleeding in menopausal
Gynae

#GastroTwearls 3/

IDA

With GI symptoms
(PRCIBH GORD AP upper GI )

Or asymptomatic

Or weight loss

Refer to Gastroenterology
2WW if > 55 / 60 (as per local rules)

Need coeliac screen result
Book CT scan if > 5% wt loss
Pt available if 2WW?

#GastroTwearls end/