Iron deficiency anaemia (IDA) means your body does not have enough iron to make healthy red blood cells, so less oxygen gets carried around your body — which is why you feel so tired. In adults, especially those over 50, low iron is often caused by slow, invisible bleeding somewhere in the digestive tract. The bleeding can be so slight that you never notice it in the toilet, but over weeks or months it is enough to drain your iron stores. Conditions like bowel cancer, polyps, stomach ulcers, and others can all cause this kind of hidden blood loss (called occult bleeding). Finding the source early is important — and reassuring, because most causes turn out to be benign.
The most common thing people notice is tiredness that does not improve with rest, and feeling breathless with activities that normally would not bother you. You might also look paler than usual, feel your heart racing or pounding (palpitations), or find it hard to concentrate. Some people develop headaches. In more severe cases, chest discomfort can occur. Many people first find out they are anaemic through a routine blood test — their GP checks it and notices the numbers are low, even though the person did not feel dramatically unwell. A positive bowel cancer screening test (FOBT) alongside low iron is a combination that needs prompt attention.
If your iron is low and there is no clear reason — such as heavy periods in younger women or a very restricted diet — it is important to look inside your digestive tract to make sure nothing is being missed. This is not about assuming the worst; it is about being thorough so that if something is there, it is caught early when it is easiest to treat. Mr Nguyen can perform both a colonoscopy (a camera examination of the large bowel) and a gastroscopy (a camera examination of the oesophagus, stomach, and top of the small bowel), covering the whole digestive system from both ends.
A blood test will confirm iron deficiency anaemia — your doctor will look at your ferritin (iron stores), haemoglobin (the protein in red blood cells that carries oxygen), and the size of your red blood cells. A colonoscopy and gastroscopy are the key investigations to find the cause. If both of these are normal, a capsule endoscopy — where you swallow a tiny camera in a pill — can examine the small bowel, which sits between the two scopes and is otherwise hard to see.
Treatment targets the underlying cause. Iron supplements — taken as tablets or given through a drip directly into your vein (intravenous infusion) — replenish your iron stores and make you feel better. If the investigations find something such as a polyp, an ulcer, or anything else, that is addressed appropriately. If no digestive cause is found after thorough investigation, the team will look at other possible explanations — including blood disorders or dietary causes — and refer accordingly.
Mr Nguyen makes the investigation process as straightforward as possible. Colonoscopy and gastroscopy are often performed together on the same day under the same light sedation — so you only need one day of preparation and one admission. If any polyps or other findings are discovered during the scopes, they are treated at the same time where possible, avoiding the need for a second procedure. When an iron infusion is clinically appropriate, it is often arranged on the same day as the scopes, saving you a separate visit. After the procedures, Mr Nguyen will explain the findings clearly at a follow-up appointment and coordinate with haematology or gastroenterology if further specialist input is needed.
If your iron is low and no simple explanation has been found — particularly if you are over 50 — please seek a specialist assessment promptly rather than simply starting iron tablets and waiting to see if they help. A positive bowel cancer screening (FOBT) test alongside iron deficiency anaemia is an urgent combination that should not wait.
Your GP will refer you to Mr Nguyen, and in most cases you will be seen within one to two weeks. At the consultation, Mr Nguyen will review your blood results, discuss your symptoms, and arrange the appropriate investigations — typically a colonoscopy and gastroscopy performed together on the same day. You will receive a clear explanation of all findings at a follow-up appointment, and any further management, including iron replacement, will be coordinated from there.
It can happen — particularly if you follow a vegetarian, vegan, or very restricted diet, since iron from plant sources is less easily absorbed by the body. However, diet alone is not a safe explanation in most adults, especially those over 50. Digestive causes must be properly looked for before assuming it is dietary, because assuming it means possibly missing something important.
In most adults with unexplained iron deficiency anaemia, yes — both are recommended to check the whole digestive tract thoroughly. Bleeding can come from the stomach or upper small bowel just as easily as from the large bowel. Mr Nguyen performs both and can arrange them on the same day to make things easier for you.
Severe anaemia can make you feel quite unwell and can put strain on your heart if untreated. More importantly, if the anaemia is being caused by something in your digestive tract, finding it early — when treatment is simplest — gives you the best outcome. That is why prompt investigation matters, even when you feel only mildly unwell.
Mr Ba Nguyen consults at his rooms in Heidelberg and operates at Warringal Private Hospital, Heidelberg, and Epworth Eastern, Box Hill. A GP or specialist referral is required.