A Diagnosis to Chew On

New-onset microcytic anemia is commonly due to chronic iron deficiency. The fact that the microcytic anemia is accompanied by new abdominal pain arouses concern about bleeding resulting from gynecologic conditions (such as fibroids or endometriosis), gastrointestinal causes (such as duodenal ulcer, gastritis, inflammatory bowel disease, or diverticulitis), or a malignant condition. Additional information is needed about the presence of heavy menses, changes in bowel habits or hematemesis, pregnancy, weight loss, and possible lead exposure.