Iron deficiency

Hi there,
Does anyone have iron deficient anemia? If so, is it because of the acid reflux or polyps in your stomach?
Thanks
Lisa

Here's some info on:polyps

http://www.ncbi.nlm.nih.gov/pubmed/17059515?dopt=Abstract

Hi there,

It's a tricky question. I think I have become more iron deficient since taking a PPI. I always had low ferritin, but a good haemoglobin. - until I took a PPI. I now have iron infusions. The PPI can make it difficult to extract the iron from food as you need stomach acid for iron absorption, though you may still get some from any red meat you eat.

But it's a dammed if you do-dammed I'd you don't situation because off PPI you are more likely to have inflammation or ulceration, if your acid levels, or normal protection against the acid, are somehow not functioning correctly. So you could lose iron from small but persistent blood loss within the digestive tract.

There used to be a simple test done on faeces, testing for presence of blood. Some places use this for bowel cancer screening, but generally (certainly in the UK) the test has been replaced with colonoscopy. That's fine if you're looking for bowel cancer, but if you're looking for microscopic blood loss in the small intestine it doesn't help, nor does a colonoscopy tell you anything about any possible blood loss from gastritis!! If where you are, the FOB test is available, it would be worth doing, as it would help determine if your anaemia is due to blood loss rather than malabsorption.

Being a woman, monthly losses just add to the problem and if you have any problems gynae wise it's worth getting a handle on those too - minimise your losses if you can.

Lastly, underactive thyroid can also cause anaemia and it's worth making sure that has also been checked.

If you're tolerance of iron tablets isn't great, or you just can't keep up your stores, infusions are simple and effective. But more than anything, you need to get to the bottom of the cause of the deficiency, or at least rule out as many things as you can. Remember that lots of people take a PPI and don't get iron deficient or have problems with polyps - so make sure that there's nothing that's been missed.

Having said that, I'm an odd case - my iron stores bottom out every six months, and the only thing that's different is the PPI. But if I don't take it I'm frightened I'll bleed from inflammation instead! I also have a hernia, and some articles suggest they somehow cause blood loss, though the exact mechanism is never explained.

MMM

Hi Lisa, sounds like you may have a mixture of causes - is your haematologist happy that all necessary checks have been done? I quite like the infusions - I'd been so deficient for so long, but the GERD or the PPI tipped me over the edge and now I get the IDA treated (every cloud....).

I've always wondered if steroids would calm down inflammation in the stomach - they use them enough for inflammation further down! I think you can't take oral steroids without causing further gastritis, but I have wondered for a while if a systemic injection would just calm everything.

Is there any treatment for the polyps on offer?

MMM

I have to add that the IBDs and the colon cancers can cause loss of blood from small to large amounts. I had a large nasty colon tumor but never noted any blood however my surgeon said I had been bleeding.

A esophagogastroduodenoscopy (EGD)

Using the endoscope, your doctor can look for    ulcers,  inflammation, tumors, infection, or bleeding. Tissue samples can be collected (biopsy), polyps  can be removed, and bleeding can be treated through the endoscope. Endoscopy can reveal problems that do not show up on X-ray tests, and it can sometimes eliminate the need for exploratory surgery.

The American Cancer Society is now distributing at many of their education sites the fecal occult blood test (FOBT) used to find occult blood.  There was a long time this test was the mainstay in the ER but than it was pulled.  Glad to see the tests are coming back.