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Dr. Andrew Rynne

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Suggest treatment for persistent sinus infection

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15903 Questions

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Posted on Mon, 20 Mar 2017 in Blood Disorders
Question: Male, age 77, healthy. Went to an Urgent Care facility on XXXXXXX 29th for sinus infection. Routine blood check showed RBC count 4.2 on their scale of 4.5-5.9 (x10). The nurse practitioner declared me anemic and wants to send me to a G.I. doctor to start an exam. My annual exam back in Oct of 2016 showed 4.66 on a scale of 4.00-6.00. I asked for a home screen of stool samples first, but the G.I. doctor wants me to come in immediately for an endoscopy. (Also had a very good report on a colonoscopy in January 2016) Is this an over reaction? YYYY@YYYY
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Answered by Dr. Michelle Gibson James 1 hour later
Brief Answer:
need to look at the MCV part of the blood test

Detailed Answer:
HI, thanks for using healthcare magic

A low rbc may indicate anemia but since it was normal a few months ago , then repeating it should be considered particularly not all type of anemia point to problems with the GI tract

Iron deficiency (low levels of iron) anemia can indicate, in some persons that there are problems with the GI tract but in that case the MCV on your blood test would be low. If you have the result , you can check this.

The MCV is done in all complete/full blood counts

The MCV can give an indicator if it is likely iron deficiency or another type of anemia. If this is normal or high then you may want to consider speaking to your general doctor about the need for endoscopy, would not likely be needed.
If it is low, then the test should be done.

Additionally the normal colonoscopy in XXXXXXX 2016, means that no lesions are likely to be there now, this is the reason that this test is scheduled years apart, lesions take years to grow.

The endoscopy would look at your esophagus and stomach , if you have symptoms related to these areas and the MCV is low then it may be necessary

If you have no symptoms and the MCV is normal or high then the need for the endoscopy should be re evaluated.

Summary: (1) since you had a recent normal test, the full blood count should be repeated
(2)a normal colonscopy a year ago means that lesions should not be present at this stage
(3)a low MCV would indicate iron deficiency anemia--- if this is the case, then you should consider testing of the upper GI tract (esophagus and stomach). One of the more common reasons for iron deficiency is a lesion in the GI tract
(4)If the MCV is normal or high then you should consider speaking to your GP about the need for further testing... not likely needed

I hope this helps,feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 17 minutes later
Sounds logical to me. Thanks Dr. XXXXXXX
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Answered by Dr. Michelle Gibson James 6 minutes later
Brief Answer:
no problem

Detailed Answer:
If you have any further issues, can let me know
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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