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Iron Deficiency Anaemia – Information for GPs

Referral criteria / commissioning position

Referral to secondary care if:

  • anaemia is IDA (refer to gastroenterology)

The likelihood of cause being found increases with age and severity of anaemia. Consider this when deciding on routine, urgent or 2 week wait referral.

  • For patients with normal Hb but low ferritin, check coeliac screen and refer if >50 yrs old

Urgent (2 week wait) referral for:

  • Upper GI cancer
  1. Dysphagia
  2. Unintentional weight loss
  3. Persistent vomiting
  4. Epigastric mass
  5. Age > 55 with unexplained and persistent recent onset dyspepsia
  • Lower GI cancer
  1. Definite palpable right sided abdominal mass probably involving large bowel
  2. Definite intraluminal (not pelvic) rectal mass.
  3. Unexplained iron deficiency (levels as per the current guidelines)

Investigations prior to referral (do not delay 2 week referral for these)

FBC, U&E, LFTs, ferritin, coeliac screen, urine analysis, CRP

Information to include in referral letter

  • History, treatments and interventions tried in primary care including the results
  • Relevant past medical/surgical history
  • Drug history (prescribed and non-prescribed)
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption
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