What is iron deficiency anaemia?

Iron is used by the body to make haemoglobin, the component in red blood cells that transfers oxygen from the lungs to cells throughout the body. Having insufficient iron means that your body will not be able to produce enough haemoglobin. This is called iron deficiency anaemia.

 

Causes of iron deficiency anaemia

Your iron levels can be low for several reasons:

• You are losing blood constantly or regularly. The most common cause of regular blood loss is heavy menstruation in women of childbearing age. Patients of both sexes can experience blood loss from the gastrointestinal system.
• You are not absorbing sufficient iron from your diet. Iron is absorbed in the upper part of the small intestine, and conditions that affect this area (e.g. coeliac disease) may lead to iron deficiency.
• You do not have enough iron in your diet. Iron is contained in a wide range of foods, including red meat, fish, eggs, dried fruit, and dried beans, so it is relatively rare for this to be the only cause. It is more usual for someone to be losing more iron than they are taking in because of one of the problems above.

 

Gastrointestinal bleeding and iron deficiency anaemia

Bleeding from the gut can be either obvious (frank) or unseen (occult). It can occur in different regions of the digestive tract and it can be due to a range of causes:

• Colitis: due to ulcerative colitis or Crohn's disease
• Bowel cancer
• Angiodysplasia (collections of blood vessels in the colon or small bowel, which can slowly ooze blood).

 

Symptoms of iron deficiency anaemia

In some people, iron deficiency anaemia does not cause any symptoms. If you do get symptoms, you may feel an overall sense of lethargy and tiredness. You may also experience an increased rate of breathing after even light activity as your body tries to compensate for the lack of oxygen in the blood.

Rarely, there are physical changes, including pale skin, smooth tongue, dry or ridged nails and painful sores around the edges of your mouth. If your iron deficiency anaemia is due to gastrointestinal bleeding, you may notice blood in your faeces.

 

Diagnosing the cause of iron deficiency anaemia

If iron deficiency is detected through a routine blood test, careful assessment is then vital to properly identify the cause of iron deficiency. Once a definite cause is found, the appropriate treatment plan can be put in place.

The Gastrorenterology and Hepatology team at The Physicians' Clinic has particular expertise in the assessment and management of patients with iron deficiency anaemia, and all necessary investigations are available. We would be delighted to see you and we will work through the following steps:

• A careful history will be taken, including details of your normal diet and, in women, information about your periods (frequency and heaviness).
• We will ask you in detail about any visible signs of blood loss and explore any associated symptoms that you have been experiencing.
• Diagnostic tests may then include additional blood tests, upper gastrointestinal endoscopy (gastroscopy), and colonoscopy.
• Biopsies may be taken during the endoscopy procedures. Sometimes additional investigations, including video capsule endoscopy, may be needed.