Anaemia and blood loss question

[ryanroks1]

Hi everyone

I'm currently awaiting a consultation to arrange a colonoscopy, and in the mean time my symptoms are being treated by Pentasa. Since starting the Pentasa, I've felt a significant improvement and many of the symptoms I was initially experiencing have completely disappeared - and I haven't noticed blood in weeks.

I was told I'd need another blood test to confirm that the treatment is working, and I expected this to be fine since the improvement in my health would indicate so. However, I received a call this morning and was told I'm even more iron deficient than I was last time...

Could this be possible without having lost more blood, or does it mean I'm still actively losing it? I'm really lost because there has been no blood, or definitely much less than before (maybe not visible). I suppose it explains why I'm extremely tired still, but I expected the blood test to have improved if I'm honest.

EDIT: I thought I should add that I am not anaemic normally, and I was told on the first blood test that I was ever so slightly iron deficient because of the blood loss.

 

[nogutsnoglory]

You can be having microscopic blood loss or scar tissue interfering with iron absorption. That's my case anyway and was surprised to find im anemic yet again.

 

[ryanroks1]

You can be having microscopic blood loss or scar tissue interfering with iron absorption. That's my case anyway and was surprised to find im anemic yet again.

Thanks for your prompt reply. How common would these be?

 

[nogutsnoglory]

I don't know the rate of frequency but iron absorption is a common problem with IBD. I'm sure many aren't absorbing due to inflammation, scar tissue, resected intestines and for other reasons like blood loss

 

[alex_chris]

I'm currently awaiting a consultation to arrange a colonoscopy, and in the mean time my symptoms are being treated by Pentasa. Since starting the Pentasa, I've felt a significant improvement and many of the symptoms I was initially experiencing have completely disappeared - and I haven't noticed blood in weeks.

Unrelated question first, are you a UC patient or a Crohn's disease patient? I assume you are the former because of Pentasa. For Crohn's, Pentasa is not recommended any more, as it principally helps to fight inflammation in the colon and not in the small intestine where Crohn's is principally located.

I was told I'd need another blood test to confirm that the treatment is working, and I expected this to be fine since the improvement in my health would indicate so. However, I received a call this morning and was told I'm even more iron deficient than I was last time...

Did they test stool samples for blood. Did you see any blood in your stool? Generally, as mentioned above, an active IBD can lead to small, but constant blood loss at the areas most affected. But even without any blood loss, iron deficiency can develop if you had or have active inflammation. I take quite a lot of iron supplements to fight iron deficiency and have had to do this for years to keep my iron levels somewhat in the normal range.

Could this be possible without having lost more blood, or does it mean I'm still actively losing it? I'm really lost because there has been no blood, or definitely much less than before (maybe not visible). I suppose it explains why I'm extremely tired still, but I expected the blood test to have improved if I'm honest.

EDIT: I thought I should add that I am not anaemic normally, and I was told on the first blood test that I was ever so slightly iron deficient because of the blood loss.

Here I would just ask again, how did they know it was because of blood loss?
Second, you can be slightly anaemic (say a haemoglobin level of 12), but your long term iron (ferritin) might already be quite too low. Even if you are back to normal and feel well, your ferritin levels won't have been replenished (it takes months of supplements or infusions or just doing really, really well) so haemoglobin might have fallen further. Do you have any details on your blood tests?

 

[ryanroks1]

Unrelated question first, are you a UC patient or a Crohn's disease patient? I assume you are the former because of Pentasa. For Crohn's, Pentasa is not recommended any more, as it principally helps to fight inflammation in the colon and not in the small intestine where Crohn's is principally located.



Did they test stool samples for blood. Did you see any blood in your stool? Generally, as mentioned above, an active IBD can lead to small, but constant blood loss at the areas most affected. But even without any blood loss, iron deficiency can develop if you had or have active inflammation. I take quite a lot of iron supplements to fight iron deficiency and have had to do this for years to keep my iron levels somewhat in the normal range.

Could this be possible without having lost more blood, or does it mean I'm still actively losing it? I'm really lost because there has been no blood, or definitely much less than before (maybe not visible). I suppose it explains why I'm extremely tired still, but I expected the blood test to have improved if I'm honest.



Here I would just ask again, how did they know it was because of blood loss?
Second, you can be slightly anaemic (say a haemoglobin level of 12), but your long term iron (ferritin) might already be quite too low. Even if you are back to normal and feel well, your ferritin levels won't have been replenished (it takes months of supplements or infusions or just doing really, really well) so haemoglobin might have fallen further. Do you have any details on your blood tests?

Thanks for your reply. I'm not yet diagnosed so I don't know which I am, and unfortunately I'm still waiting for my first colonoscopy. My first blood test showed low hemoglobin and a high platelet count. They also gave me a fecal calprotectin test which showed inflammation was present. I asked for medication and was given Pentasa to help minimise symptoms during my wait, and it appears to be working. As for the blood loss, I was bleeding almost every time I emptied my bowels and this has now completely stopped, hence my confusion.

The second blood test results I just got back have not yet been properly explained to me, and all I've been told is that I need another one because I'm heavily iron deficient. Thanks for explaining the process and how it's possible to still be iron deficient without the blood loss - it's definitely reassured me.