Iron Deficiency Anemia
Clinical Presentation and Treatment of a Common Blood Cell Condition
Anemia related to iron deficiency can easily be treated, but it can also be a sign of another more serious condition.
Anemia is the condition of having fewer functional red blood cells (RBCs) than normal, either with abnormalities in the RBC itself or a decrease in the number of RBCs. There are many types of anemia classified. One of the most common is iron deficiency anemia.
Causes
Inadequate dietary intake of iron can be a cause of iron deficiency anemia for vegetarians who don't take iron supplements, but it is otherwise uncommon where meat is a typical part of the culture's diet. More commonly, iron deficiency is the result of blood loss, particularly unnoticed blood loss. Whenever bleeding occurs, the body responds by making more RBCs, but because the iron intake may not likely increase, not all RBCs will contain the iron they need.
This is especially important for rectal bleeding. Conditions like colon cancer may cause bleeding into the stool (hematochezia), which can go unnoticed until the patient eventually has symptoms from iron deficiency anemia. It is also important for women, who are more prone to iron deficiency than men because of menstrual periods. Any heavy menstrual bleeding or bleeding between periods may cause iron deficiency if enough time elapses.
Less common causes of iron deficiency anemia include malabsoprtion, such as after surgical removal of the intestines, and loss of iron in the urine, such as with a rare condition called paroxysmal nocturnal hemaglobinuria.
Symptoms and Signs
The principal symptom of iron deficiency anemia, as with anemias in general, is fatigue because of a lower capacity to carry oxygen in the bloodstream. The surface beneath the eyelids and other mucous membranes may look pale. Other signs may include the development of esophageal webs and changes in the fingernails characteristic of iron deficiency anemia.
Laboratory blood studies reveal a lower hemoglobin level, a lower percentage of blood occupied by RBCs (hematocrit), and a smaller cell size (mean cell volume, or MCV). Additional blood tests show decreased iron, often decreased ferritin, and increased total iron-binding capacity (TIBC). When a peripheral blood smear is viewed under a microscope, the RBCs appear smaller with a much paler center than normal RBCs.
Treatment
The treatment of iron deficiency simply involves taking iron supplementation and addressing any bleeding that is present. For cases where colon cancer screening had not been recently performed, occult rectal bleeding.should be ruled out by a primary care physician and followed up, if necessary, with colonoscopy performed by a gastroenterologist.
