What are the different causes of anaemia seen commonly in the general population? Iron deficiency is the commonest. Bleeding due to piles, excess bleeding during menstruation and slow blood loss from the stomach due to gastritis or duodenal ulcers are common, but they present late.

What are the early symptoms of anaemia?

Tiredness, easy fatiguability with minimal exertion, palpitations, dizziness are general symptoms. Some symptoms may point to the cause of anaemia. This may include blood in stools due to piles or even cancer of the rectum, colon or anorectal canal. Black stools may indicate blood coming down from a higher source in the gastrointestinal tract.This may include cancers of the stomach, oesophagus or bleeding ulcers.

What are the common causes of anaemia in the elderly?

Besides bleeding piles, we should be vigilant about bleeding from the stomach due to the long term consumption of aspirin. Aspirin is used as a blood thinner to prevent the recurrence of thrombosis after a heart attack, angioplasty or bypass surgery or a stroke. Checking for occult blood in stools is important. However, do not stop aspirin unless you see your doctor. Cancers in the mouth, oesophagus, stomach and colon need to be evaluated on an individual basis. Blood cancers, myeloma, lymphoma and B12 deficiency needs to be ruled out.

Can kidney disease cause anaemia?

Certainly. Tumour in the kidneys, a urinary blad-alcohol intake, proper vaccination against Hepatitis B virus and lifestyle changes to prevent progression of fatty liver is suggested. Cancer of the liver may present with jaundice and anaemia.

What about anaemia in girls and women?

Excessive menstrual blood loss and failure to take adequate iron supplements is the commonest cause. Bleeding after menopause should receive Low haemoglobin is anaemia no matter what is the cause. Though generally associated with an Iron deficiency or blood loss or inadequate intake of iron Vitamin B 12 or other supplements, there are many other causes that cause anaemia and need to be diagnosed early enough for proper and early treatment. der cancer, prostate cancer that has spread to the bones can cause anaemia. Chronic kidney failure is an important cause of anaemia. High blood urea, high creatinine, hypertension and swelling over the feet are early symptoms. Be vigilant about the colour of urine. Red coloured urine or blood in urine needs to be evaluated on an urgent basis.

What about low haemoglobin associated with liver disorders?

Cirrhosis of the liver due to chronic alcohol consumption, chronic Hepatitis B virus infection or a fatty liver progressing to cirrhosis can present with all symptoms of anaemia. Most of them have very prominent veins in the oesophagus that can bleed. These individuals may either vomit blood or may have black tarry stools. Avoid excessive prompt attention, as this may indicate cancer of the uterus. Cancer of the cervix can present with blood loss and anaemia. Human papillomavirus vaccination is indicated in young girls and young women to prevent cancer cervix. Annual Pap smear in women, mammography on annual basis in high-risk individuals for cancer breast are strongly recommended. Any change in the menstrual cycle should be brought to the notice of your gynaecologist.

What about anaemia in children?

Certain congenital disorders of red blood cells like sickle cell disease, thalassemia, deficiency of certain enzymes like G6 PD and anaemia due to hookworm infestation are common. Incidences of blood cancers and lymphoma are also increasing in children as in adults. Chronic anaemia in children can impair their growth and development, hence they need to be evaluated and treated on an urgent basis.

What are the common symptoms of Vitamin B 12 deficiency?

This is more commonly seen amongst vegetarians. Blackening of skin, premature greying of hair, loss of hair are common. Mild loss of memory, tingling and numbness in any part of the body, commonly of the feet and hands is common. Easy fatiguability and weight loss, digestive disorders are associated with Vitamin B 12 deficiency. In some months administration of injections of Vitamin B12 are necessary on life long basis.

How serious is anaemia?

It entirely depends on the cause. Iron deficiency and Vitamin B 12 deficiency should be recognised early and treated. However sickle cell anaemia or Thallesemia require lifelong treatment. In other situations, the treatment depends on the cause. This may be the treatment of liver or kidney failure or the treatment of leukaemias, lymphoma or cancers of various organs.

How to prevent anaemia?

If you have a family history of genetic blood disorders, then genetic counselling before marriage is suggested. Certain symptoms like mouth ulcers, difficulty in swallowing, weight loss, black stools or blood in urine and stools should not be ignored. Irregular menstrual cycles, menses after menopause, arthritis, recurrent jaundice with anaemia and prolonged fever or unexplained weight loss needs evaluation and treatment.

Categories : Health

Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.

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