The usefulness of routine small bowel biopsies in evaluation of iron deficiency anemia

Scott W. Grisolano, Amy S. Oxentenko, Joseph A. Murray, Lawrence J. Burgart, Ross A. Dierkhising, Jeffrey A. Alexander

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Background: Iron deficiency anemia (IDA) may be the sole manifestation of celiac disease. The role of routine small bowel biopsies obtained during endoscopy in the evaluation of IDA is unclear. This study assessed the usefulness of routine small bowel biopsies in patients presenting with IDA. Study: Evaluation of 103 consecutive patients with IDA undergoing panendoscopy with routine small bowel biopsies was performed. All patients had a diagnosis of IDA with either a ferritin less than 15 μg/L or iron saturation less than 8%. Celiac disease was defined as total or partial villous atrophy with intraepithelial lymphocytosis, histologically, and a clinical response to gluten free diet. Gastrointestinal symptoms were recorded. Results: Nine patients (8.7%) were diagnosed with celiac disease. Of these patients, endoscopic lesions potentially responsible for IDA were found in 33%. We found no statistically significant difference when comparing reports of diarrhea, weight loss, abdominal pain, nausea or vomiting, aspirin or NSAID use, or menopausal status with celiac disease status. Conclusions: Routine small bowel biopsies to evaluate for celiac disease are indicated in the evaluation of patients with IDA. The finding of endoscopic lesions that may otherwise explain IDA should not preclude small bowel biopsy.

Original languageEnglish (US)
Pages (from-to)756-760
Number of pages5
JournalJournal of clinical gastroenterology
Issue number9
StatePublished - Oct 2004


  • Biopsy
  • Celiac disease
  • Endoscopy
  • Iron deficiency anemia

ASJC Scopus subject areas

  • Gastroenterology


Dive into the research topics of 'The usefulness of routine small bowel biopsies in evaluation of iron deficiency anemia'. Together they form a unique fingerprint.

Cite this