Iron-Deficiency Anemia of Gastrointestinal Origin

Anemia, defined as hemoglobin (Hgb) below 13 g/dl in males and below 12 g/dl in females, is common in the geriatric population. A third of anemia in the old results from nutritional deficiency, of which iron deficiency is a major contributor. Iron deficiency seldom if ever results from dietary inadequacies in Western society; iron deficiency suggests blood loss, typically of gastrointestinal (or genitourinary) origin, in the geriatric population. Anemia of iron deficiency always warrants evaluation for an etiology and entails gastrointestinal evaluation. After addressing the etiology of iron deficiency, iron replacement therapy is provided. Oral iron is adequate in most cases, although it is associated with adverse effects and may lead to nonadherence. In such cases several options are available for parenteral iron administration. The chapter discusses the many gastrointestinal causes of iron-deficiency anemia and the approach for evaluation and management.