Anemia resulting from a lack of healthy red blood cells, is a common complication with Inflammatory Bowel Disease (IBD), such as Crohn’s Disease and Ulcerative Colitis. It can be caused by multiple factors, including decreased nutrient intake, malabsorption of food, increased energy expenditure and/or increase in blood loss.
The anemic state is strongly correlated to your quality of life. Extreme fatigue, a common symptom of anemia, can make you too tired to complete daily tasks and enjoy your life.
Three different types of blood cells are produced in the body: red blood cells, white blood cells, or infection fighting cells, and platelets. These assist your blood’s ability to clot.
Red blood cells contain an iron-rich protein, called hemoglobin, which gives blood its red color. Hemoglobin is required to transport oxygen within red blood cells from the lungs to other parts of the body. It also carries carbon dioxide from other parts of the body to the lungs to be exhaled. A low hemoglobin level leads to anemia.
Iron, vitamin B12, folate and other nutrients are needed to produce hemoglobin and red blood cells.
Factors contributing to iron deficiency
- Intestinal bleeding
- Decreased absorption of iron in people with involvement of the duodenum (part of the small bowel where iron absorption occurs)
- Inflammation that inhibits production of red blood cells
Factors contributing to vitamin B12 deficiency
- Disease or resection of the part of small bowel where absorption of vitamin B12 occurs
- Inflammation of the stomach, as seen in some people with Crohn’s disease
- Bacterial overgrowth
Factors contributing to folic acid deficiency
- Insufficient dietary intake
- Treatment with Sulfasalazine or Methotrexate
Not everyone experiences symptoms, however when they do, symptoms may include:
- Shortness of breath
- Pale skin
- Cold hands or feet
Your doctor will check for anemia periodically if you have inflammatory bowel disease.
Iron-deficient anemia is treated orally or intravenously. The method depends on the individual person, including the severity of their iron deficiency and tolerance of oral therapy.
In people with iron deficiency, oral iron may be prescribed if they have no active disease, or mild IBD with mild to moderate anemia. Intravenous supplementation may be done in people with moderate to severe IBD activity, severe anemia, or who do not tolerate or respond appropriately to oral iron.
Folate supplements may be recommended for IBD patients with low levels, or who are being treated with Sulfasalazine or Methotrexate.
Vitamin B12 is offered in pill form, via injections, or by IV therapy.