Understanding Low Iron Levels and the Role of Colonoscopy
Low iron levels, also known as iron deficiency, can significantly impact your health. Iron is a vital mineral that helps produce haemoglobin, a protein in red blood cells responsible for transporting oxygen throughout the body.
When a patient presents with low iron levels, their GP may recommend a colonoscopy as part of the diagnostic process. This is because low iron levels can sometimes be caused by internal bleeding in the gastrointestinal (GI) tract. A colonoscopy is a procedure that allows doctors to examine the lining of the colon and rectum using a flexible tube with a camera. It is an essential tool for identifying potential sources of bleeding, such as polyps, ulcers, or tumours.
Who is typically recommended a colonoscopy for low iron?
Not everyone with low iron needs a colonoscopy - many cases are explained by diet, heavy menstrual periods, or pregnancy. However, investigation is generally recommended more promptly in situations where there is no obvious cause, particularly:
- Men of any age with unexplained iron deficiency
- Postmenopausal women with unexplained iron deficiency
- Anyone with associated symptoms such as:
- rectal bleeding,
- a change in bowel habit,
- or unexplained weight loss
- A family history of bowel cancer or bowel polyps
Your GP's referral letter will reflect how these factors apply to your situation, and Dr Golani will discuss this further with you at your consultation.
Common causes identified during colonoscopy
A colonoscopy can identify a range of causes for iron deficiency, most of which are treatable and not related to cancer. These include small polyps, diverticular disease, angiodysplasia (small abnormal blood vessels in the bowel lining), and less commonly, bowel cancer. Identifying the exact cause allows Dr Golani to recommend the right treatment, whether that's simple polyp removal during the same procedure or further management of another finding.
The Importance of Early Detection
Colonoscopy is not only useful for diagnosing the cause of low iron levels but also plays a crucial role in preventing serious conditions like colorectal cancer. By identifying and removing precancerous polyps during the procedure, doctors can reduce the risk of cancer development. Early detection and treatment of GI issues can improve overall health and prevent complications.
When to seek medical attention
Low iron levels should never be ignored, as they can be a sign of underlying health issues. A colonoscopy is generally safe tool that helps uncover the root cause of iron deficiency and ensures timely intervention. If your GP recommends a colonoscopy, it is an important step toward understanding and improving your health.
Why See a Colorectal Surgeon for Your Colonoscopy?
When Dr Sanjeev Golani performs your colonoscopy, you are being examined by a specialist colorectal and general surgeon, not only an endoscopist. This becomes especially important if your colonoscopy identifies something that requires treatment. Many clinicians perform excellent diagnostic colonoscopies, but if a finding such as a polyp, diverticulitis, significant haemorrhoids, or bowel cancer requires surgical management, you may need to be referred to a surgeon for the next step - meaning additional waiting time, a new referral, and re-explaining your history to another doctor.
Because Dr Golani is a qualified colorectal and general surgeon who is also accredited by GESA in advanced endoscopic techniques, he can perform your colonoscopy and, where appropriate, proceed with treatment himself - as your ongoing treating doctor, without a second referral. This includes conditions such as diverticulitis, colonic and rectal polyps, haemorrhoids, anal fistulas and fissures, and bowel and rectal cancer where surgical treatment is required.
Frequently Asked Questions
What's the difference between a gastroenterologist and a colorectal surgeon performing my colonoscopy?
Both are well qualified to perform a diagnostic colonoscopy. The key difference is what happens if something is found that needs treatment. A gastroenterologist is a physician and does not perform surgery, so a finding such as a polyp, diverticulitis, or a condition needing surgical management means a referral to a separate surgeon. Dr Golani is a colorectal and general surgeon who is also accredited by GESA to perform colonoscopy, so he can identify a condition and, where appropriate, treat it himself as your ongoing surgeon.
If my colonoscopy finds a polyp, diverticulitis, or haemorrhoids, will I need to see another specialist?
Not necessarily. Because Dr Golani is a surgeon as well as an endoscopist, he can continue as your treating doctor for many conditions found during a colonoscopy, including polyps requiring surgical removal, diverticulitis, haemorrhoids, and anal fistulas or fissures. This avoids the need for a separate referral and a new specialist consultation for common findings.
Is a colorectal surgeon as qualified to perform a colonoscopy as a gastroenterologist?
Yes. Dr Golani is accredited by the Gastroenterological Society of Australia (GESA) in advanced endoscopic techniques, meeting the same training and competency standards expected of any specialist performing colonoscopy in Australia, in addition to his surgical training and fellowship.
Will Dr Golani be my ongoing treating doctor if something is found during my colonoscopy?
In most cases, yes. If your colonoscopy identifies a condition within his scope of practice, such as polyps, diverticulitis, haemorrhoids, or bowel or rectal cancer, Dr Golani can continue as your treating surgeon for diagnosis, treatment planning, and any surgery required, without needing to refer you elsewhere.
Does having my colonoscopy with a colorectal surgeon cost more than with a gastroenterologist?
Colonoscopy fees are generally comparable between specialists performing the same procedure, and a Medicare rebate applies in the same way. Dr Golani's team can provide a detailed cost estimate at your consultation, and you can also review general information about hospital and insurance costs here.
Does low iron always mean I have bowel cancer?
No. Most people investigated for low iron do not have bowel cancer. Low iron has many possible causes, including diet, heavy periods, polyps, ulcers, or other benign sources of bleeding in the gastrointestinal tract. A colonoscopy is recommended because it is the best method to check the colon for a serious cause and identify the actual source, whatever it turns out to be.
What if my colonoscopy comes back normal - where is the low iron coming from?
A normal colonoscopy is a good outcome and rules out the colon as the source. If the cause is still unclear, Dr Golani may recommend a gastroscopy to examine the stomach and upper gut, since iron deficiency can also arise from causes such as coeliac disease or a stomach ulcer. Dietary intake, heavy menstrual bleeding, and reduced absorption are also common explanations that don't require further endoscopic investigation.
Will I need both a colonoscopy and a gastroscopy?
Some patients with unexplained iron deficiency are recommended both a colonoscopy and a gastroscopy, since bleeding or absorption problems can arise from either the upper or lower gastrointestinal tract. Dr Golani is certified by GESA to perform both procedures, and where appropriate they can often be done together under the same anaesthetic, minimising the need for a second admission.
Do I need to stop my iron tablets before a colonoscopy?
Iron supplements do not usually need to be stopped before a colonoscopy, but they can sometimes darken bowel motions and make bowel preparation slightly less predictable. Dr Golani's team will give you specific bowel preparation instructions ahead of your procedure, and you should mention any supplements or medications you are taking at your consultation.
How urgent is a colonoscopy for low iron or anaemia?
Timing depends on your individual situation, including your age, symptoms, and how significant the anaemia is. Iron deficiency in men of any age, and in postmenopausal women, is generally investigated more promptly, since there is no expected physiological cause for it in these groups. Your GP's referral will indicate the urgency, and Dr Golani's clinic can accommodate urgent referrals within the week on request.
Is a colonoscopy for low iron covered by Medicare?
A colonoscopy performed to investigate a clinical concern such as unexplained iron deficiency is assessed differently to a purely screening procedure, and a Medicare rebate generally applies when the procedure is referred by a GP or specialist. Out-of-pocket costs vary depending on your hospital and health fund. Dr Golani's team can provide a detailed cost estimate once your consultation has confirmed the recommended procedure.
Your Consultation
If you have been recommended a colonoscopy with Dr Golani the first step is a consultation. Dr Golani will provide further discussion regarding the specifics of your diagnosis during your consultation. Additionally, you'll have the opportunity to select the hospital for your procedure and potentially set the date for your procedure.
The best surgical hospitals are available for your surgery:
- Sydney Adventist Hospital, Wahroonga - Sydney
- The Mater Hospital, North Sydney - Sydney
- Norwest Private Hospital, Bella Vista - Sydney
- Hornsby Ku-ring-gai Hospital, Hornsby - Sydney
To schedule a consultation with Dr Golani, please contact our team for a consultation with Dr Golani. We have appointments available at three convenient locations across Sydney:
Please note that a GP referral will be required prior to your consultation.
