Do I need endoscopy and colonoscopy

I was recently diagnosed by my pcp with anemia caused by chronic blood loss and was referred to a gastroenterologist.  At my appointment I was seen by a nurse practitioner who stated that the anemia was only slight, that the red cells were trying real hard, and that I could probably take a wait and see position as it might clear up by itself.  She was more concerned with some abdominal pain and nauseau I suffer occasionally and ordered an ultrasound as well as an endoscopy and colonoscopy (scheduled for 10/1) the latter mostly for my peace of mind.  Later that day she called my home and said they needed to reschedule the endoscopy and colonoscopy because three weeks was too long to wait because of the anemia.  When I called to reschedule, it took them three days and as many calls from me for them to return my call, they didn't seem too concerned and we weren't able to reschedule anyway.  She also prescribed Aciphex and I later learned that there is a warning about not taking Aciphex if you're also taking Lanoxin (which I am).  I also have VT (I have an ICD) and AFib.  Both have recently been very symptomatic.  I am really uncomfortable with the treatment at this point.  How important is it to have the tests at this time?  Can I take a wait and see approach?  I have a lot of faith in my pcp, but since he referred me to the specialist, shouldn't they prevail?  I really don't know what to do at this point and would really appreciate some input.

[Kevin Pho, MD]

Anemia caused by chronic blood loss certainly warrants at least a colonoscopy.  An upper endoscopy should also be considered as well.  This is because the GI tract is one of the more common causes for chronic blood loss leading the anemia.  These causes can include a polyp, cancer, or diverticulosis.  

If your blood count is stable (i.e. not rapidly decreasing), then these tests are not necessarily emergently needed, but they should be done at some point - ideally within the next few weeks.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[testermom]

Forgot to mention, in case it's important, I am a 62-year old female.