Consultant Gastroenterologist, Beacon Medical Services Group

“A common reason patients come to see me is unexplained anaemia. In many cases, it’s easily treated, but sometimes it can be a sign of underlying gastrointestinal blood loss, which is why early and thorough investigation is so important.”

What is anaemia, and when should people be concerned? 

Anaemia is often picked up on routine blood tests and can cause symptoms such as fatigue, breathlessness, or reduced energy levels. While it may be linked to diet, in adults, we always need to understand the underlying cause — particularly if it persists or worsens.

What tests are usually carried out first? 

I would typically begin with a detailed clinical history alongside blood tests, including a full blood count, ferritin, and iron studies. These help confirm whether iron deficiency is present and guide further investigation.

When is further investigation needed?

If iron deficiency anaemia is identified without an obvious explanation, we need to consider the possibility of blood loss from the gastrointestinal tract. In these situations, procedures such as an upper endoscopy (OGD) and colonoscopy allow us to directly assess the digestive system and identify the cause.

Are these procedures safe? 

Yes — both OGD and colonoscopy are very safe, routine procedures. In my experience, patients are often reassured once they understand how straightforward they are. Importantly, they provide clear answers and help us move quickly to the right treatment.

What happens after diagnosis?

Treatment depends on the cause. Many patients respond well to iron tablets, although some may not tolerate them. In those cases, iron can be given intravenously, alongside monitoring to ensure levels improve and remain stable.