Anemia and Its Relationship With IBD

Anemia is a term that is used to describe a low red blood cell count. There are three different general types of blood cells — red blood cells, white blood cells, and platelets. Red blood cells are the part of blood that carries oxygen to all the parts of the body.

Why Are People With IBD at Risk?

People who have inflammatory bowel disease (IBD) are at risk for anemia. One reason for this is the poor absorption of vitamins and minerals that can occur because of inflammation or diarrhea. If the intestines can't absorb enough iron, folate, vitamin B12, and other nutrients, the body won't have what it needs to create more red blood cells.

Another reason for anemia in people who have IBD is the blood loss that can occur with Crohn's disease and ulcerative colitis. A continual loss of blood, especially in amounts that can't be easily replenished by the body, can result in anemia.

The good news is that many cases of anemia can be treated effectively. When IBD is gotten into remission (or as close as possible) and the bleeding lessens, that will help with anemia significantly. Iron supplements or even iron infusions may also be used to treat anemia in some cases.

Symptoms

Many cases of anemia are considered mild, but even mild anemia can cause symptoms and may require treatment. More severe forms are less common but can lead to a host of complications, some of them quite serious, such as organ damage or heart failure. Symptoms of anemia include:

• Fatigue
• Dizziness or lightheadedness
• Irritability
• Numbness or coldness in hands or feet
• Pale skin
• Shortness of breath and rapid heartbeat with mild exertion
• Weakness
• Chest pain (this is rare)

Types of Anemia

There are several different kinds of anemia, including aplastic, iron deficiency, vitamin deficiency, chronic disease, and hemolytic anemias. The treatment used will depend on the type of anemia and its underlying cause. If the anemia has lead to the development of other complications, treatment might be needed for those problems as well.

• Aplastic Anemia: When bone marrow stops producing new blood cells, it is a condition called aplastic anemia. Aplastic anemia is fairly rare and can be inherited or caused by radiation and chemotherapy, exposure to toxins, use of drugs, autoimmune disorders (such as lupus), viral infection (such as hepatitis), pregnancy (extremely rare), and bone marrow diseases (such as leukemia). Treatments include blood transfusions, medication, and even bone marrow transplants. Due to new advances in treatment, there is now a good prognosis for people with this disorder.
• Iron Deficiency Anemia: Iron deficiency anemia, the most common type of anemia, can be caused by a lack of iron-rich foods, iron malabsorption, and blood loss. This type of anemia can be treated by increasing the amount of iron-rich foods in the diet or with iron supplements. If blood is being lost through internal bleeding, the primary cause of the bleeding will also need to be addressed.
• Vitamin Deficiency Anemias: Poor absorption of folic acid and vitamin B12 due to intestinal disorders such as IBD or other conditions, as well as not consuming enough of these vitamins through your diet, can cause this type of anemia. Along with iron, folic acid and B12 are necessary to produce red blood cells. Treatments for this type of anemia can include replacing the vitamins that are not being absorbed, such as by taking B12 shots and folic acid supplements.
• Anemia of Chronic Disease: Some diseases can interfere with the production of red blood cells, including AIDS, cancer, liver disease, chronic inflammatory diseases, kidney failure, and rheumatoid arthritis. The mode of treatment for this type of anemia includes getting the underlying condition under control.
• Hemolytic Anemias: In this type of anemia, the destruction of red blood cells is taking place faster than new red blood cells can be produced. Some of the causes include autoimmune disorders or medications used to treat infections. This type of anemia can result in an enlarged spleen due to the large amount of abnormal red blood cells that have collected in it. If an autoimmune disorder is a cause, the treatment will include medication to suppress the immune system, because the immune system is working overtime and destroying the red blood cells.

Diagnosing Anemia

Anemia is easily diagnosed through a simple blood test. Often, anemia comes on very slowly and is not noticeable as it develops over a long period of time. It can take some time to treat anemia, especially if treatment involves iron or other supplements to spur the body to produce more red blood cells. In severe cases of anemia, blood transfusions may be used. If you are at risk for anemia ​and are experiencing the symptoms listed above, talk to your healthcare provider about getting tested.