Geriatrics
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Recent evidence suggests that vitamin B12 deficiency in the elderly is more than classic pernicious anemia. Instead, it is a continuum from negative B12 balance to frank deficiency, which can be detected by low serum B12 levels long before changes occur in hemoglobin levels. Current findings in the literature suggest that subtle B12 deficiency is indeed clinically significant. Treatment may prevent significant neurologic and/or hematologic disease.
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When ambulatory geriatric patients present with gastrointestinal (GI) complaints, a complete workup is necessary to determine whether the cause is a functional problem or organic disease. Some of the more common organic diseases found in the elderly GI patient include peptic ulcer disease, neoplasms, inflammatory bowel diseases, and diverticular disease. Special considerations that must be given the geriatric patient during workup, diagnosis, and treatment are discussed.