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My 96 yr old mother has been told she has to have an

endoscopy because she is anemic...
My 96 yr old mother has been told she has to have an endoscopy because she is anemic. She has been anemic a few times in the past due to low iron. She doesn't remember having any kind of bleeding at all. She has had 3 blood transfusions and feels great now yet the doctor wants to do this procedure as he thinks she has an ulcer. I am against it as I feel it is too risky at her age but the doctor says if she waits to see how she does then she could have a really bad bleed and they wouldn't be able to do much for her at that point. I really am confused as to why they are insisting on the endoscopy...
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Answered in 5 minutes by:
3/15/2018
Doctor Jennifer
Category: Medical
Satisfied Customers: 104
Experience: Surgery Fellow
Verified

Hi, I'm Dr Jennifer and I'm a surgery fellow.

It's rare to need three blood transfusions for iron deficiency anemia. I think it's probable that she does have an occult source of bleeding, which is almost always from the stomach or first part of the small intestine, or from the colon. And if it's from the stomach or small intestine, which her doctor wants to check, it is often caused by a bacteria which can be cured with antibiotics. They can also treat ulcers with the endoscope, or take biopsies, because the other cause for bleeding from the stomach or duodenum is cancer.

I have seen elderly ladies like your mother bleed to death from ulcers in that area, so it is something that could happen. You are right that an endoscopy is a procedure that does have risks, though. But unlike surgery, endoscopies are done under conscious sedation and generally are much lower risk than surgery. And if done in a controlled setting, planned, it's much safer than if they had to do it urgently if she were bleeding severely.

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If she has been bleeding from an ulcer in the stomach or duodenum, she might never have seen blood. Bleeding that high in the gut means that the blood is digested by in the intestines just like food, so you don't necessarily see anything different in the stool.

Every 96 year old lady is different, so the risk balance is difference with every patient. If she has a bad heart or bad lungs, or is very frail and week, maybe it is too risky. But I think about my own 94 year old grandmother, and if she had the same picture, I would want her to get the endoscopy. That said, I wouldn't want to her have some types of surgery, even to save her life, because they're I understand they're too risky for her. So it may certainly be that an endoscopy might not be a risk she wants to take.

Does that help? What else can I clarify? Do you have other questions?

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Doctor Jennifer
Category: Medical
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Experience: Surgery Fellow
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