The prevalence of non-malignant gastrointestinal (GI) disease in patients with iron deficiency anemia (IDA): a systematic review and meta-analysis

De Silva, Ravindu ORCID: https://orcid.org/0009-0003-5184-5978, Thomas, John P., Murali, Navanith, Senathirajah, Lukschana, Rajendra, Roshan, Bialecki, Sophie, Chan, Simon S. M. and Alexandre, Leo (2026) The prevalence of non-malignant gastrointestinal (GI) disease in patients with iron deficiency anemia (IDA): a systematic review and meta-analysis. European Journal of Gastroenterology & Hepatology. ISSN 0954-691X

Microsoft Word (OpenXML) (Accepted Manuscript Jan 26) - Accepted Version Available under License Creative Commons Attribution. Download (326kB)

Abstract

Objective: Gastrointestinal pathology is a major cause of iron deficiency anemia (IDA). Whilst previous studies have focused on establishing the prevalence of malignant gastrointestinal (GI) disease, the prevalence of non-malignant GI disease in patients with IDA has not been analysed systematically. We performed a systematic review and meta-analysis to determine the prevalence of normal findings, individual non-malignant findings and malignancy in patients with IDA. Methods: We searched Medline, Embase and Scopus from inception for observational studies that reported the prevalence of individual upper and lower GI pathologies amongst adults (≥18 years) with confirmed IDA who underwent endoscopic investigation. We also sought to establish the prevalence of normal endoscopic findings within the IDA population as well as the prevalence of non-malignant and malignant GI pathology amongst clinically relevant subgroups. Results were synthesized using a random effects meta-analysis. Results: A total of 8563 citations were screened and 39 articles were included from four continents comprising 9807 patients with IDA. Overall, the most prevalent upper GI finding was H. pylori gastritis (27.0%); and the most prevalent lower GI finding was hemorrhoids (10.0%). The overall prevalence of upper GI malignancy was 5.0% and the prevalence of colorectal cancer was 8.0%. 52.0% of upper GI endoscopies and 66.0% of lower GI endoscopies did not detect any abnormalities. Conclusions: The estimated prevalence of individual malignant and non-malignant GI disease will serve as guide in the context of clinical decision making prior to endoscopy in patients with IDA. Further population-based studies are needed, particularly amongst relevant subgroups.

Item Type:	Article
Uncontrolled Keywords:	iron-deficiency anemia,gastrointestinal,cancer,endoscopy,systematic review,sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Related URLs:	https://www.ovid.com/jnls/eurojgh/abstra...
Depositing User:	LivePure Connector
Date Deposited:	27 Jul 2026 15:42
Last Modified:	30 Jul 2026 15:00
URI:	https://ueaeprints.uea.ac.uk/id/eprint/103953
DOI:	10.1097/MEG.0000000000003160

Actions (login required)

View Item