Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Eur J Gastroenterol Hepatol. 2012 Feb;24(2):109-16. doi: 10.1097/MEG.0b013e32834f3140.
Iron deficiency anaemia (IDA) is the most common form of anaemia worldwide. In men and postmenopausal women the commonest cause of IDA is blood loss from lesions in the gastrointestinal tract, making it a common cause of referral to gastroenterologists. Causes of IDA relate either to blood loss or iron malabsorption. After confirmation with laboratory tests, gastrointestinal evaluation is almost always indicated to exclude gastrointestinal malignancy. Specific patient groups such as premenopausal women, patients with low-normal ferritin and iron-deficient patients without anaemia may need an individualized approach. A small proportion of patients have recurrent or persistent IDA despite negative standard endoscopies. These patients with obscure gastrointestinal bleeding usually require evaluation of the small bowel with capsule endoscopy or double balloon enteroscopy. Treatment should involve prompt iron replacement plus diagnostic steps directed towards correcting the underlying cause of IDA. Oral iron replacement is cheap and effective, but parenteral (intravenous) therapy may be required due to intolerance, noncompliance or treatment failure with oral therapy.
缺铁性贫血（IDA）是全球最常见的贫血形式。在男性和绝经后妇女中，IDA 的最常见原因是胃肠道病变导致的失血，这使其成为转介给胃肠病学家的常见原因。IDA 的病因要么与失血有关，要么与铁吸收不良有关。通过实验室检查确认后，几乎总是需要进行胃肠道评估以排除胃肠道恶性肿瘤。特定的患者群体，如绝经前妇女、铁蛋白水平低但正常和无贫血的缺铁患者，可能需要采取个体化的方法。尽管进行了标准的内镜检查，但仍有一小部分患者反复或持续出现 IDA。这些有隐匿性胃肠道出血的患者通常需要进行胶囊内镜或双气囊小肠镜检查。治疗应包括迅速补铁以及针对缺铁性贫血根本病因的诊断措施。口服铁补充剂既便宜又有效，但由于不耐受、不遵医嘱或口服治疗失败，可能需要使用肠外（静脉）治疗。
