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Screening tests

Authoring team

Haematology:

  • full blood count - macrocytosis suggests vitamin B12 or folate deficiency; microcytosis, iron deficiency
  • folate - deficiency suggests proximal mucosal disease, as upper small intestine is main site of absorption, for example, coeliac disease
  • vitamin B12 - dietary lack unlikely except in vegetarians; consider pernicious anaemia, Crohn's ileitis, pancreatic disease
  • blood film e.g. Howell Jolly bodies in coeliac disease

Biochemistry:

  • calcium - low in vitamin D deficiency
  • albumin - protein losing enteropathy; for corrected calcium
  • ferritin - low in malabsorption or due to menstruation
  • zinc

Immunology:

  • endomysial antibody in coeliac disease

Stool:

  • Sudan stain for faecal fat
  • microscopy - look for ova, cysts, parasites; Giardiasis is most likely infective cause in the UK
  • pH - less than 6.0 indicates fermentation of unabsorbed carbohydrate

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