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GERD Maintenance — ESEGH MCQ

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HardGastroenterologyGERD MaintenanceESEGH

A 67-year-old man has recurrent iron deficiency anaemia six months after a complete response to iron. High-quality gastroscopy and colonoscopy were normal, and renal tract evaluation is negative. Which small-bowel investigation is preferred next?

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Correct answer: B — Small-bowel capsule endoscopy as the next investigation

After acceptable negative gastroscopy and colonoscopy, recurrent or refractory iron deficiency anaemia warrants small-bowel assessment once the renal tract has also been evaluated. Capsule endoscopy is preferred because of its sensitivity for mucosal lesions; device-assisted enteroscopy is usually directed by a capsule finding.

Reference: BSG guideline for management of iron deficiency anaemia in adults (Published 2021): https://www.bsg.org.uk/clinical-resource/guidelines-iron-deficiency-anaemia-in-adults; ESGE guideline update on small-bowel capsule endoscopy and device-assisted enteroscopy (Published 2022): https://www.esge.com/small-bowel-ce-and-dae-for-diagnosis-and-treatment-of-sb-update-2022