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Ulcerative Colitis
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Posted 10/20/2008 12:07 AM (GMT 0)

37 Years old, uc for 16 years. Within the last 2 years had a couple of flare ups, however just recently lots of bleeding, low iron & b12 however only 2-3 bm a day and not diahrrea. I have had 5 blood transfusions in the last 2 years. my hemoglobin goes from 10 to 6 in a matter of a month and a half

I am currently taking 4 Lialda a day, 5 iron pill a day and 40 mg of prednisone (which is killing me with the side effects). Had a colonoscopy in July and was only mild irritation.

Is there anyone out there that has had similar symptons.

I have been living with this for 16 years but can't seem to live with the bleeding now and the blood transfusion every couple of months.

Have to go next week for 2nd opinion

Posted 10/20/2008 1:36 PM (GMT 0)
You might want to look into Folic acid - I think that helps make red blood cells, i used to get very tired - felt like I was incredibly unfit and it felt like my muscles couldn't get enough oxygen - I guessed maybe having been in a flare for a while my body was making too many white (immune) cells and not enough red - since starting it i've not felt tired like that again.

Some-one proposed the followign theory and it seems fairly sound and backed up by a reasonable amount of evidence -
The body's natural responce to an inflammation/infection is decreasing the iron transport from the intestines into the blood. This is done because bacteria need iron for growth. However when the inflammation is INSIDE the intestines, this defence mechanism works contra productive.
This causes the following situation :
Iron is a catalyzer in The Haber-Weiss reaction : h2o2 + Fe(iron) +2 --> Fe(iron) +3 + OH + HO (hydroxyl free radicals)

Simply said : A big amount of iron in your intestines creates a very big amount of hydroxyl free radicals !
Free Radicals can do substantial damage to your intestine cells.
As a result, your defence system initiates an attack on itself : The intestine cells. An inflammation is the result !
Even worse, the bone marrow, which is responsible for creating hemoglobin, doesn't receive any iron anymore.
Without the iron, it can't create red blood cells and thus the person gets anemia as a bonus !
The bone marrow sends a message to the intestines : "Please dissolve more iron and transport it to me !"
The intestines starts creating large amounts of soluble iron. It can't be transported to the bone marrow however.
Result : This is a vicious cycle, you won't be able to break !

The iron in the intestines causes a second problem. Because of the excess of iron in the intestines, the bacteria in the mucus of the intestines will thrive. It will completely destroy the natural balance of bacteria in the intestines. The bacteria start producing acids and the intestines cells have no protection for that. So, the amount of digestive enzymes also decreases rapidly.

Have you noticed any difference since taking iron suppliments?
Posted 10/20/2008 3:42 PM (GMT 0)
This is something I will check into.

A little better since taking iron however, as I come off of the prednisone I have bleeding and therefore the blood transfusion and lack of iron. Recent test before transfusion hemoglobin was 6

Have hard time with prednisone I think I have all of the posssible side effects there are and I've only been on it for 8 weeks.

I am seeing another gastro docter for a second opinion on thurs.

Thanks

Posted 10/20/2008 4:40 PM (GMT 0)
I am glad you are seeing another doc. The only time I was ever hospitalized was for anemia and still did not get a blood transfusion. That would seem a last resort and risky, not routine as they seem to be doing to you! Lots of iron is also very irritating to your gut and might cause bleeding. Your treatment regimen is very unusual, especially for only mild irritation.
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