TY  - JOUR
AU  - Emmanuel Andres
AU  - Jean-Edouard Terrade
AU  - Xavier Jannot
AU  - Edward Nasco
AU  - Marie Caroline Taquet
AU  - Marie Caroline Dalmas
AU  - Alpha Diallo
AU  - Camille Martinez
AU  - Noël Lorenzo-Villalba
PY  - 2026
DA  - 2026/05/11
TI  - Iron Deficiency Anemia of Digestive Origin without Overt Hemorrhage: From Celiac Disease and Helicobacter pylori to Pernicious Anemia, Tea Consumption, Pica, Heyde Syndrome, and Hereditary Hemorrhagic Telangiectasia
JO  - Medicine and Clinical Science
VL  - 8
IS  - 2
AB  - Iron deficiency anemia (IDA) is the most prevalent nutritional deficiency worldwide, yet its etiology
frequently escapes detection when overt gastrointestinal hemorrhage is absent. A heterogeneous
spectrum of digestive conditions — operating through malabsorption, achlorhydria, competitive luminal
inhibition, chronic mucosal inflammation, and acquired coagulopathy — accounts for a clinically
important and systematically under investigated subset of IDA. This review examines eight major
non-hemorrhagic or occult-hemorrhagic digestive causes of IDA: celiac disease, Helicobacter pylori
gastritis, autoimmune atrophic gastritis and pernicious anemia (Biermer disease), dietary polyphenol
consumption (tea), pica and pagophagia, Heyde syndrome, and hereditary hemorrhagic telangiectasia
(Rendu-Osler-Weber disease). For each condition, we detail the pathophysiology of iron depletion,
the optimal diagnostic strategy integrating serological, endoscopic, and genetic approaches, and the
evidence-based therapeutic management including the pivotal role of intravenous iron formulations
when oral supplementation is insufficient or contraindicated. A unified diagnostic algorithm is proposed
to guide clinicians in the systematic evaluation of IDA without evident hemorrhage. Recognition of
these non-hemorrhagic causes is essential to avoid diagnostic delay, minimize transfusion exposure, and
ensure targeted treatment of the underlying condition alongside iron repletion.
SN  - 2690-5191
UR  - https://dx.doi.org/10.33425/2690-5191.1164
DO  - 10.33425/2690-5191.1164