Anemic and referral for colonoscopy

[Andso]

I went for some regular bloods recently and my iron levels came back as low so I was re sent for iron studies on my bloods.

I have just got a call from my doctor to say that I am anemic and he is referring me for a colonoscopy. Is this usually the first step if one is anaemic? Or should he have performed further tests that are less invasive?

Thanks for reading

I would have thought you would have a FIT test first, blood test to look for inflammation markers and a blood test for celiacs.

It does sound a little drastic, I could understand if you've had blood in your poo (FIT test needed) but otherwise, there are many things that can cause low iron.

That does seem drastic unless you have other symptoms. I've recently told I'm anaemic although my iron levels are fine (although on the low side). I was sent for another blood test to check for blood cancer (I don't have it) and now told to take extra iron for a couple of months to see if this sorts the anemia out. I have no symptoms of anything except tiredness.

Yes I think you would have a FIT test first. If you've blood in your stool, then they want to have a look and find out why.

In other countries they are done as screening tools, I am quite glad they do the FIT test as a triage solution here though.

I am assuming you are in the UK? You can buy a FIT test in Boots so you could check for yourself if so.

Thanks for all the replies, yeah I was thinking the same. Then I thought maybe there was something else on my bloods that he has seen that has made his refer me for a colonoscopy.
He also mentioned that in the US it is standard that after anemia to refer for colonoscopy so maybe he is looking to that for reference. Yes based in UK

This is not the first approach no.

A big cause of iron deficiency anaemia can be malignancy (cancer) or bleeding of some sort. Have you had any bowel symptoms? Any dark stools. A colonoscopy is a fairly sensible investigation in this scenario.

No bowel symptoms no, I'm not feeling tired or have any other anemic symptoms

Wow I continuously have low iron. My doctors just keep giving me ferrous sulphate. I've never been suggested for additional tests

How low is it? I'm periodically low iron but also have no other symptoms but have never had any referral except a prescription for iron supplements. Perhaps I don't meet the criteria for anaemia but ferritin levels often sit around 13-16.

They will want to find out where you are bleeding from if your iron is very low.

When I was anaemic I had at various times: Colonoscopy and Endoscopy, and gynaecological investigations. They need to/should investigate if/what is the underlying cause.
Just giving you supplements is not enough.

That is what happened when I had continued anemia and I did have bowel symptom as well. I assumed the op did as well. I was diagnosed with UC

I don't have any symptoms, I don't even have the symptoms of low iron as in tiredness, breathless etc.. I will call today and find out the levels. I have always had low levels of iron from my pregnancies years back, but haven't had them checked till recently.

Thanks for all replies, I will probably go ahead with the procedure as if I didn't and something was found down the line I wouldn't forgive myself.

In a way it’s good, why faddle about with fit test if they’re willing to go straight to having a look with colonoscopy.

How’s your diet? Do you eat enough iron containing foods?
Do you still have period, are they heavy.

There are other causes for iron deficiency anaemia.

Personal question OP, how old are you? Sometimes older people who don't have a previous history of anaemia get referred for colon investigation, Especially if you are post menopause and don't have monthly periods which might impact on iron levels.

I recently had a colonoscopy and, whilst I can't say it was the most enjoyable experience of my life, it was a great relief to hear there was nothing sinister lurking in my colon, especially as I had a friend who passed of colon cancer last year. However, they did remove polyps which could eventually cause an issue - most of us get polyps as we age. To be honest, at my age, it is quite nice to have one less bit of my body to worry about for a while!

I think anyone who is offered one should take one - I believe in some countries regular colonoscopies are routine after a certain age.

My diet would be ok ISH, I don't eat red meat tho or a huge amount of green leafy veg. I'm 46 but haven't had any periods for two years..

That could well be why your iron is low, I'm the same. I do also have hypothyroidism and low ferritin is very common amongst people who have that.

I had colonoscopy, gastroscopy and a scan of the bit in the middle that the other two don't reach. They're looking for microscopic bleeding of the gut lining (or were in my case).

@unsync can I ask why you were referred for these tests?

I had unexplained anaemia and my ferritin was depleted. This was as a result of a blood test taken for a health check. They didn't find anything so I'm on omeprazole and iron tablets. It was a while back, but if I stop taking the iron, my levels start dropping. I assume it's because I don't absorb it properly.

@unsync thank you

I think a lot depends on where you are and your age. My iron and haemoglobin were low for no obvious reason and I was immediately referred for a colonoscopy and a gastronomy. It turned out to be large internal piles constantly bleeding.
Other people I know had a FIT test first. I was about 55 when I was referred.

Got my bloods finally, can anyone see if they look worrying, thanks