Read on Twitter
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/
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/Lwith
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/
Check haematinicsDon’t forget coeliac screenConfirm 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 dailyAsk if bleeding from:
Nose, refer 
ENT
Haemoptysis, Resp
Haematuria, Urology
Heavy PV bleeding in menstruating 
(ask about clots / flooding) orPV bleeding in menopausal 
Gynae#GastroTwearls 3/
IDAWith GI symptoms
(PR
CIBH 
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/
