ANAEMIA

 

Anemia 

Definition : Anemia is a condition in which you don't have enough healthy red blood cells to carry adequate oxygen to your tissues.

Causes

Many medical conditions cause anemia. Common causes of anemia include the following:

Anemia from active bleeding: 

Loss of blood through heavy menstrual bleeding or wounds can cause anemia. Gastrointestinal ulcers or cancers such as cancer of the colon may slowly ooze blood and can also cause anemia.

Iron deficiency anemia: 

The bone marrow needs iron to make red blood cells. Iron (Fe) plays an important role in the proper structure of the hemoglobin molecule. If iron intake is limited or inadequate due to poor dietary intake, anemia may occur as a result. This is called iron deficiency anemia. Iron deficiency anemia can also occur when there are stomach ulcers or other sources of slow, chronic bleeding (colon cancer, uterine cancer, intestinal polyps, hemorrhoids, etc). In these kinds of scenarios, because of ongoing, chronic slow blood loss, iron is also lost from the body (as a part of blood) at a higher rate than normal and can result in iron deficiency anemia.

Anemia of chronic disease: 

Any long-term medical condition can lead to anemia. The exact mechanism of this process in unknown, but any long-standing and ongoing medical condition such as a chronic infection or a cancer may cause this type of anemia.

Anemia related to kidney disease: 

The kidneys release a hormone called the erythropoietin that helps the bone marrow make red blood cells. In people with chronic (long-standing) kidney disease (CKD or end stage renal disease (ESRD), the production of this hormone is diminished, and this, in turn, diminishes the production of red blood cells, causing anemia. This is called anemia related to or anemia of chronic kidney disease.

Anemia related to pregnancy: 

Water weight and fluid gain during pregnancy dilutes the blood, which may be reflected as anemia since the relative concentration of red blood cells is lower.

Anemia related to poor nutrition:

Vitamins and minerals are required to make red blood cells. In addition to iron, vitamin B12 and folate (or folic acid) are required for the proper production of hemoglobin (Hgb). Deficiency in any of these may cause anemia because of inadequate production of red blood cells. Poor dietary intake is an important cause of low folate and low vitamin B12 levels. Strict vegetarians who do not take sufficient vitamins are at risk to develop vitamin B12 deficiency.

Pernicious anemia:

There also may be a problem in the stomach or the intestines leading to poor absorption of vitamin B12. This may lead to anemia because of vitamin B12 deficiency known as pernicious anemia.

Sickle cell anemia: 

In some individuals, the problem may be related to production of abnormal hemoglobin molecules. In this condition, the hemoglobin problem is qualitative, or functional. Abnormal hemoglobin molecules may cause problems in the integrity of the red blood cell structure and they may become crescent-shaped (sickle cells). There are different types of sickle cell anemia with different severity levels. This is typically hereditary and is more common in those of African, Middle Eastern, and Mediterranean ancestry. People with sickle cell anemia can be diagnosed as early as childhood depending on the severity and symptoms of their disease.

More Causes of Anemia

Thalassemia

Alcoholism

Aplastic anemia

Hemolytic anemia

Anemia related to medications

Other less common causes of anemia include

thyroid problems,

cancers,

liver disease,

autoimmune diseases (lupus),

paroxysmal nocturnal hemoglobinuria (PNH),

lead poisoning,

AIDS,

malaria,

viral hepatitis,

mononucleosis,

parasitic infections

bleeding disorders, and

insecticide exposure.



Symptoms of anemia may include the following:

fatigue

decreased energy

weakness

shortness of breath

lightheadedness

palpitations (feeling of the heart racing or beating irregularly)

looking pale.

Symptoms of severe anemia may include:

chest pain, angina, or heart attack;

dizziness

rapid heart rate.

Some of the signs that may indicate anemia in an individual may include:

Change in stool color, including black and tarry stools (sticky and foul smelling), maroon-colored, or visibly bloody stools if the anemia is due to blood loss through the gastrointestinal tract;

rapid heart rate;

low blood pressure;

rapid breathing;

pale or cold skin;

heart murmur;

enlargement of the spleen with certain causes of anemia.



Tests for Anemia Diagnosis

Lab tests for anemia generally include the following:

Complete blood count (CBC): 

Stool hemoglobin test

Peripheral blood smear

Iron level

Ferritin

Folate

Vitamin B12

Lead level

Hemoglobin electrophoresis

Reticulocyte count

Liver function tests

Kidney function test

Bone marrow biopsy

Treatment of Anemia : 

- Treatment of the causative disease 

- Vitamins and minerals supplements 

- Medication 

- Blood transfusion 

- Bone marrow transplant 

- Surgery 

- Antibiotic therapy

 

Anemia Self-Care at Home

Very little can be done to self-treat anemia and medical treatment is generally needed. It is important to continue to take any medication that is prescribed for other chronic (long-lasting) medical problems. If the reason for anemia is known, then measures to keep it under control are very important. For example, if anemia is caused by a stomach ulcer, then medications such as aspirin or ibuprofen should be avoided, unless otherwise directed by a doctor.

Anemia Surgery

There are no specific surgical interventions for the treatment of anemia. However, depending on the causes of the anemia, surgery may be a treatment option. For example, if colon cancer or uterine cancer that slowly bleeds is the cause of anemia, then surgical removal of the cancer could potentially treat the anemia.

Anemia Follow-up

Follow-up care for anemia will depend on its type. Most will require repeat blood counts. Also, repeat visits to the doctor's office are generally recommended in order to determine the response to treatment.

Anemia Prevention

Some common forms of anemia are most easily prevented by eating a healthy diet and limiting alcohol use. Many types of anemia can be avoided by seeing a doctor regularly to check blood tests and when problems arise. In the elderly, routine blood work ordered by the doctor, even if there are no symptoms, may detect anemia and prompt the doctor to look for the underlying causes.

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