Written by Dr Anton Bungay for Doctify

It’s Monday morning. Getting out of bed feels even more of a challenge than usual even though you slept eight hours last night. Should you cut back on the late nights and big weekends? Probably. But the problem could be something else entirely. You could be suffering from anaemia.

Here to tell us a little more about this condition is gastroenterologist, Dr Anton Bungay.

So, what actually is anaemia?

Anaemia is a common medical condition and is frequently investigated by GPs, haematologists and gastroenterologists.

If you are anaemic it means that you have fewer red blood cells circulating around your blood stream and this means that the haemoglobin concentration in the blood is low.

Haemoglobin is an essential iron containing protein component of the red blood cell and its role is to transport oxygen from the lungs to the rest of the body. This is a critical part of energy production which powers each cell and enables us to live.

How can I tell if I have it?

If anaemia is mild you may have no symptoms at all. However, if it is significant you may feel tired, breathless and lacking in energy. You could look pale.

There are many causes of anaemia or low haemoglobin.

Broadly we divide these into categories of:

  1. Impaired production of red cells for example diseases of the bone marrow, or a lack of essential constituents to make haemoglobin and this would include a lack of iron, vitamin B12 or folate.
  2. Accelerated destruction of red blood cells in the body can occur for example in some autoimmune conditions of the blood
  3. Blood loss from the body

Why does it happen?

In pregnancy, anaemia can occur simply due to an increase in plasma volume which will dilute the haemoglobin. This is normal and usually nothing to be concerned about.

If there is not enough iron in the body then it is more difficult to produce red blood cells and this can result in anaemia. This is a specific form of anaemia called iron deficiency anaemia and it is very common.

It can come about due to inadequate dietary iron intake for example in vegetarians. It can also come about due to excessive blood loss from the body and there are many causes of this. In women the most common cause is menstrual blood loss.

Another common cause of iron deficiency anaemia is blood loss from the gastrointestinal tract and that is why patients with iron deficiency anaemia often see a gastroenterologist.

How is it diagnosed?

The doctor may take a full history and after examining the patient and considering the blood test results he or she may propose an endoscopy of the stomach (called a gastroscopy) and one of the colon (called a colonoscopy). It’s important that patients do not ignore symptoms such as severe stomach pain, indigestion or a change in bowel habit toward looser stools or rectal bleeding.

Endoscopy tests are used to pick up a whole range of serious and less serious diseases ranging from a small ulcer in the stomach to bowel cancer or even Crohn’s disease.

How is anaemia treated?

The treatment of anaemia is varied and may range from eradication or treatment of the underlying cause such as a stomach ulcer to simple supplementation of iron in the diet with tablets. In severe cases that need more immediate treatment a blood transfusion or iron infusion may be required.

Other causes of anaemia which are not related to low body stores of iron are too numerous to discuss here and their treatments can be complex. I hope this helps you understand anaemia.

 


 

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