Background: the Iron deficiency anemia (IDA) is a common cause of referral to medical departments. Chronic gastrointestinal (GI) blood loss is important cause of IDA and also an alarming sign of serious underlying disease. The information concerning ideal evaluation of the gastrointestinal tract in patients with the IDA is scant. We designed a prospective study to determine the frequency of GI tract lesions in patients with the IDA. Methodology: This cross - sectional study was conducted since January 2006 to January 2008 at Imam Hospital, Urmia in the west of Iran. The study population was comprised of 227 patients including men over 40 years and post menopausal women with probable IDA. After identification of patients, we extracted detailed data via medical records, history taking, physical examination and laboratory. Data was analyzed by the chi square and student’s t-test.

Results: the patients totally underwent 478 in : 214 upper GI endoscopies, 179 colonoscopies, and 85 bariumenema. The mean age of subjects was 61 years (SD±15), and 55% were women. Upper GI lesions (esophagitis, gastritis, peptic ulcer and gastric cancer) accounted 32.1 (73 case) percent of cases. Colonoscopy findings include: polyps of colon were found in 10 (4.4%) of cases and colon cancer in 15 (6.6%). Etiology of IDA was not detected in 126 (55.5%) of our patients.

Conclusion: We concluded despite relatively low rate of malignant gastrointestinal lesions that were found in our study, GI tract assessment is necessary in iron deficiency anemia, chiefly in the patients with symptoms related to upper or lower gastrointestinal tract.