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Anemia and concerned about colon cancer

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Ulcerative Colitis
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Posted 10/27/2011 3:37 PM (GMT 0)
I found out earlier this month that I'm iron-deficient anemic, with no obvious cause (no visible bleeding with my proctitis, though I had a flare in August; light periods). I saw my GI this morning, and I'm going to be getting a colonoscopy in a few weeks. He said anemia isn't uncommon with UC patients, however, he also mentioned the possibility of polyps or colon cancer, and that has gotten me all freaked out (I have health anxiety as well, so my mind tends to take the least little thing and run away with it).

I had a flex sig 2 years ago (no inflammation seen), and my last colonoscopy was about 7 years ago (no inflammation seen). FWIW, I'm 41. I wasn't anemic when I had my blood counts checked August 2010 (my Hgb levels were 13 then, earlier this month they were 10).

Anybody able to talk me down here?

Posted 10/27/2011 3:51 PM (GMT 0)
Are you male or female? If female are you menstruating? If menstruating are you perimenopausal - any changes in your cycle?

I've been iron-deficient for most of my adult life, but my IBD has been complicating that because of poor nutritional uptake. You're not eating meat - so how are you doing on dark leafy greens? Does your multivitamin have iron in it?
Posted 10/27/2011 3:59 PM (GMT 0)
I am female and have light periods (they've gotten lighter since I had an ovary removed in 2006 because of cysts). I'm taking iron tablets now, and I definitely feel better since starting them. I also take Vit. D3, since that was low, too. I've been eating mostly a bland, low-fiber diet since I started a light flare in August, but I've been eating a lot of sauteed spinach.
Posted 10/27/2011 4:02 PM (GMT 0)
According to the medical guidelines of American College of Gastroenterology, people pancolitus reach a .5-1% yearly risk of colon cancer after 10 years. People with left side reach this level after 30-40 years. People with UP and protosigmotitus have no elevated risk of colon cancer.

They still recommend being annual or biannual colonoscopies after 8-10 years with extensive biopsies. Many doctors want to do more sooner anyway. Family history of colon cancer increases risk of UC patients and is a reason to look sooner and more often.

Polyps are not something to worry about. The chances that they are cancerous is very low. If you get colonoscopies regularly, you are really in no danger from the more common polyops.

I wouldn't worry about it.
Posted 10/27/2011 7:13 PM (GMT 0)
I have that health-related anxiety, too. But just try and remember that as a doctor, they have to tell you that kind of stuff. It doesn't mean you have polyps or cancer, so try and relax. Iron deficiency is not uncommon with UC, and especially where you are female. If you're not willing to eat red meat, you can also try various beans and green leafy veggies. Another thing I like to do is cook stuff in my cast-ironware (soups and stews or just roasting various meats or veggies) a few times a week. If you don't own any cast-iron, I suggest getting some.
Posted 10/27/2011 7:17 PM (GMT 0)
Spinach isn't a good source of iron that's absorbed readily, so eating a lot of it won't help. It also is high in oxalate, so that, in itself, hinders the absorption.

Are you eating any meat?

You're due for a scope anyway, and definitely need to have lots of biopsies to make sure all is good and only limited to UC..nothing more.

My iron was down a bit, interestingly, because it's never been down even during my worst flare and severe weight loss. I have recently cut back on the vitamin C...over the summer, but have upped it again...which helps for absorption.

I think all of us are afraid regarding cancer/polyps....getting checked regularly and dealing with flares and continuing maintenance meds is a good thing.

q
Posted 10/27/2011 10:36 PM (GMT 0)
Hi MmeMulot-
I'm a 70 year old female whose had UC for about 9 years. Got it under control (bearable) by taking Colazal (an anti-inflammatory), probiotics and experimenting with dietary changes. My GI agreed with using the probiotics. Have never used prednizone.
At one point, I was iron-deficient and tried several types of iron pills...slow-release, etc. Found the best for me was a multi-vitamin containing iron. Also take calcium and vitamin D3 to avoid osteoporosis. (My bone density has actually increased.) Folic acid is also important to avoid colon cancer.
At this point I am learning to cook with curry and incorporating other cancer preventing foods into my diet (green tea, etc.)

Don't let your GI drive you crazy. Seems like few docs have the sense to keep their thoughts to themselves until they know for sure. Incredibly insensitive mentioning colon cancer at this point. Let the other members give you insight into the fact that each case is different. If you can, look into relaxation methods (yoga, meditation, etc.) to relieve your stress.
Best wishes.
Posted 10/27/2011 10:47 PM (GMT 0)
Thanks for the replies. I know it's unlikely, but I do worry about things like that! I didn't know Vit. C helps with iron absorption, so maybe I'll add some of that. (Though my multivitamin has some.)
Posted 10/27/2011 10:51 PM (GMT 0)
You do not have to see blood to be anemic. I had J pouch surgery for my severe UC and I am healthy now and of course not bleeding anymore but I am still anemic. It's a bit of a mystery for me right now. But it seems if I load up on the iron supplements ( I need to take Bifera twice a day) then my blood count goes up. If I stop taking the supplement, I drop. I am hoping since it's only been a year since being so sick and having my surgeries that my iron stores will regulate.
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