Pallor and fatigue
Red flags
- Iron deficiency anaemia in a man of any age, or a post-menopausal woman - occult GI malignancy until proven otherwise, requires bidirectional endoscopy
- Unintentional weight loss, change in bowel habit, or PR bleeding accompanying fatigue/pallor
- Haemodynamic instability (tachycardia, hypotension, postural drop) with severe anaemia - needs urgent assessment/transfusion, not routine outpatient work-up
- Fatigue with jaundice/dark urine - hints at a haemolytic rather than deficiency process
- Family history of colorectal cancer/polyposis syndrome in a patient with new iron deficiency
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