Introduction

Anemia is a common and often underdiagnosed condition in the elderly population. Digestive endoscopy plays a pivotal role in the etiological workup, particularly to rule out serious underlying causes such as malignancies or peptic lesions. However, the diagnostic yield of such procedures in routine clinical practice remains variable and underreported, especially in resource-limited settings.

Aims & Methods

To assess the diagnostic yield of digestive endoscopy in the investigation of anemia in elderly patients, with a particular focus on iron deficiency anemia (IDA) and vitamin B12 deficiency, and to identify specific endoscopic findings associated with these etiologies.
We conducted a retrospective descriptive study over a 6-month period. The study included all patients aged 65 years and older who underwent esophagogastroduodenoscopy (EGD) and/or colonoscopy as part of the diagnostic evaluation for anemia. Data collected included demographic information, clinical symptoms, laboratory parameters (including hemoglobin, ferritin, vitamin B12 levels), endoscopic findings, and histopathological results when available.

Results

A total of 252 patients were included in the analysis. Among them, 44 patients (17.5%) with a mean age of 71 years [68-82], had confirmed IDA, and six patients (2.4%) presented with vitamin B12 deficiency anemia, associated in all cases with histologically confirmed fundic atrophy.
In univariate analysis, IDA was statistically correlated with the presence of peptic esophagitis (p=0.04), gastric neoplasia (p=0.001), erosive gastropathy (p=0.02), and Helicobacter pylori gastritis (p=0.04). It was also weakly correlated with the presence of colorectal cancer (p=0.05).
Colonic angiodysplasias and colonic polyps were not associated with IDA in this cohort (p=0.1 and p=0.4, respectively).

Conclusion

Digestive endoscopy, particularly EGD, remains a cornerstone in the diagnostic algorithm of anemia in the elderly. It enables the identification of a wide range of underlying pathologies, from inflammatory lesions to malignancies, and guides appropriate therapeutic interventions. Early endoscopic evaluation should be encouraged in this population to prevent diagnostic delays and improve outcomes.