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Two questions, please

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GERD & Acid Reflux
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Posted 8/30/2012 7:48 PM (GMT 0)
I'm a Crohnie and have two questions.
The first question is: I posted last week about my gastritis flare up. Since then I have been on nexium 40 x2, famotidine 40 x 2, riopan gel when needed, carafate 4g (started to have severe nausea). But I can't see the slightest improvement. My colon started to hurt as I skip doses of my colon meds. Being a GERD pt for 14 years, it has never taken me such a long time to start to feel better. Is this normal w gastritis?
The second question is about anemia. I'm too weak, sleep a lot and feel that my heart will come out of its place. My GI prescribed a children's multivitamin syrup w iron but it hurts my stomach. Other Crohn's fellows mentioned that they take iron in the form of iv infusions. The last time they gave me iv iron in the ER I felt as if my stomach was going to burst out of pain after only a couple of minutes and asked them to stop the infusion. When I called my GI for help, he was in a rage, yelled at me and told me to see him to prescribe intramuscular iron injections. What about you GERD folks? How do you treat anemia?
Your replies are highly appreciated.
Posted 8/30/2012 10:49 PM (GMT 0)
Hi there

I have always had poor iron stores but never been anaemic. However, once I started on a daily PPI my haemoglobin gradually fell. It went so low this year that I asked to be referred to a haematologist but I got sent back to the surgical folk and had repeat gastroscopy and colonoscopy to look for causes of the anaemia. They didn't find any, apart from some antral gastritis. So finally I saw a haem cons who gave me Cosmofer infusion. I don't tolerate oral iron by the way, it gives me abdominal pain and diarrhoea. I was worried about the infusion as I have allergies, but it went fine. My haemoglobin was 96 beforehand and I go back soon for repeat blood test. It took about 3 weeks to kick in but I'm noticing less breathlessness now and my leg muscles are not protesting all the time!

Which infusion did they try? Did they do a test dose first? I definitely wouldn't try any oral iron with Crohn's. I.m may work, but you'll need a lot of injections. Can you try a different preparation as infusion?

If your HB is less than 9 it may be worth pushing for a blood transfusion just to get you back on your feet...?

MMM
Posted 8/30/2012 11:20 PM (GMT 0)
MMM, thank you very much. I do too have chronic antral gastritis in addition to doudenitis. I know the cause which is side effects from my chron's meds. I'm surprised that my GI did not order a CBC test. Well, yes, I have shortness of breath.
Last time I had anemia I was given those Cosmofer im injections and as you mentioned they were many but my GI didn't allow me the right to object. The HB was raised to 11 and that was satisfactory for my GI then.
Posted 8/31/2012 1:11 PM (GMT 0)
hi minnietoty,

you are on an unusually high dose of acid suppressing meds. it is not possible that your stomach is still not recovering. have you gotten a EGD to check your stomach?

I am slightly anemic due to thalassemia trait. I wasn't aware and doc never told me if there is any restriction on PPI drug for anemic patients.
Posted 8/31/2012 2:54 PM (GMT 0)
Doesn't long term use of PPIs have the possible side effect of pernicious anemia, and also iron-poor anemia? I started taking folic acid when I started taking Nexium many years ago - I'm done with the ppis but continue taking folic acid. I know that won't help with the iron deficiency, but I hope it helped with the B12 issues.
Posted 9/1/2012 4:21 PM (GMT 0)
WJF and Kazbern, thank you very much. I never knew that ppis cause anemia. I'm very weak and dizzy. Today, I feel I will start a colon flare up: d and severe right lower quadrant pain. I haven't had this pain in month. I'm complying to what my GI asked me not to have any flare ups and see him next week. Hopefully, the ppis and antacids kick in and gastritis becomes better.
Posted 9/1/2012 4:52 PM (GMT 0)
I get iron infusions as I can't tolerate oral iron. Have you asked to try a different type of iron? Some types are easier to tolerate than others. I've had constant gastritis for the last 3 years with no improvements so I can't help in that area.
Posted 9/1/2012 5:27 PM (GMT 0)
Babygirl10150, thank you very much. I will talk about the different types of iron injections with my GI. Sorry that you have been suffering from gastritis for such a long time.
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