This testing may be reasonable but is it necessary?

Patient

Q: I am a 68 year old female with a ferritin of 8.5, Iron is 71, TIBC of 555, % sat 13, Hbg. 12.9 and Hct. 40. In 2008 I had lower results on these tests and took a couse of ferrous sulfate for 4 months. I also realized I probably had been taking too much Excedrin for my aches and pains from arthritis and fibromyalgia and I dicontinued that. On recheck in 3 months all tests were normal. This time my family doctor wants to refer me to an Internist Gastroenterologist for possible colonoscopy and endoscopy. He is a big proponent of colonoscopys and has been pushing me to have one for several years. I somewhat feel that he had finally found a good excuse and he is frightening me with his "possible" reasons for the low ferritin. I am relatively healthy for my age and am having no problems related to my blood work. I admit I'm very leery of having either test. Thoughts? Thank you.

Doctor

A:   I agree that many patients see tests as toublesome and unecesary and ultimately it is your decision but I would agree with your physician. In view of your anemia i would also recommend a screening colonoscopy to just make sure that there is no underlying colon cancer etc which could be masking the symptoms. Also in any case now a colonoscopy or a fecal test is recommended as a screening test for all over the age of 50 years. Colon cancer can be treated if caught in the eartly stages. And if your test is clear then you are good to go for another 10 years. I hope you take these points into consideration before making your decision. All the best.

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