frank100 wrote:
FOBT(+)=GI occult bleeding.
microcytic hypochromic anemia is not equal to GI occullt bleeding. he is old his diet can be low in iron. so why will I scope him now. I can find nothinh there. Just a simple question on the history (diet) and a negative FOBT is enough for not to acope him...
he is not even 50, and no risk factors in the question mentioned, so he still does not need rutinary endoscopy...so FOBT is a good approach in this setting...NOT ALWAYS
he is not OLD, he is midde aged....
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| frank100
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fecal ocult blood test (AKA: guayac)
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| tolito
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thanks frank.
the most common cause of microcytic anemia in a male in that age group is said to be gi bleeding. the most common site of bleeding in the age group is upper gi. the first test is FOBT (guaiac test). cos it is cheap and easy to perform and will readily give you a pointer that your initial suspicion is correct. next step would be to confirm your suspicion.
i think the morale is that you want to do less invasive and cheap stuff first.
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| Sea_gull
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study_ing wrote:
42 yr old male with microcytic anemia....why do an FOBT on him..y not colonoscopy directly.
Dear
Listen when a patient of Microcytic anemia comes you have to know First of all
What is the cause of microcytic anemia???
In males GIT bleeding is the most common cause of microcytici anemia;
This bleeding can be right from Esophagus (varices) ------------------> anus (hemorrhoid).
In between it can be
- peptic ulcer gastritis due to chronic aspirin ingestion Angiodysplasia IBD Colon Ca Diverticulosis Polyp
(just a few causes)
From GIT bleeding point of view we divide GIT into two parts
- Part above the Ligament of Treitz (duodenojejunal junction)= Upper GIT Part below this ligament = Lower GIT
Bleeding from upper GIT present as occult blood or melena
Bleeding from Lower GIT presents as frank blood
This is just general principal otherwise exceptions are there which depends upon the amount of bleed.For example mass bleed in the peptic ulcer will be as frank blood in the stool and slight blood blood in Ca colon may be present as occult blood detected by FOBT.
This is the reason whenever you come across as GIT bleed you always start investigating from above down.If anyone wants to add something or correct ,most welcome
GL
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