Haemoglobin
in the red blood cells carries oxygen around the body. Without
sufficient oxygen the body cells cannot function properly. Anaemia,
the situation in which there is inadequate haemoglobin in the
blood, results in a person feeling tired, lacking energy, and,
sometimes, becoming breathless. Anaemia has many causes which
may vary from society to society. In the Third World, for example,
anaemia is commonly a result of malnutrition, or blood loss
from intestinal infestation by hookworm etc. The former is not
very common in western society, the latter extremely uncommon.
Anaemia may result from a poor diet, particularly if it is low
in iron (iron deficiency anaemia), from excess blood loss, from
diseases and situations in which the blood cells are damaged
or unable to carry sufficient haemoglobin or in diseases affecting
the bone marrow when inadequate new red blood cells are produced.
Iron deficiency anaemia can be the result of poor general nutrition,
either through poverty or ignorance, or from a chosen diet that
is particularly low in iron e.g. some extreme forms of vegetarianism.
The diet may be adequate but intake may be compromised by malabsorption
in the gut. Anaemia due to blood loss may be acute - the sudden loss of large amounts of blood in an accident, an operation, during childbirth - or chronic - heavy periods (see Menorrhagia), haemorrhoids (see |Haemorrhoids/Piles) or a bleeding peptic ulcer (see Indigestion/Ulcer/Heartburn). Conditions in which the red cells become damaged and cannot carry sufficient haemoglobin include various types of poisoning, severe infections and autoimmune disease. The haemoglobin itself may be abnormal as in sickle-cell disease. Bone marrow disease in which insufficient, or abnormal red cells are produced, include pernicious anaemia and malignant conditions such as leukaemias , myeloma and cancerous deposits. Bone marrow may also be damaged by poisons (including chemotherapy) and radiation. The majority of cases of anaemia seen by a doctor are from iron deficiency or chronic blood loss (particularly menorrhagia. see Menorrhagia)
Many people who are pale are not anaemic, some people with normal colour are anaemic. Anaemia has to be diagnosed by a blood test, which may also suggest the cause of the anaemia. Little red cells (microcytes), for example, suggest iron deficiency anaemia, large red cells (macrocytes) are found in a number of conditions including pernicious anaemia. If iron deficiency is suspected the iron content of the blood is also measured. Once diagnosed the anaemia is treated accordingly. Iron deficiency anaemia can be treated with iron tablets, initially, and establishing an adequate diet. Excess blood loss from whatever cause must be dealt with at source. Generally iron is also given in these cases to make up for that which has been lost. In acute, severe blood loss a blood transfusion may be necessary. Other investigations are required, often many, including extensive blood examination, X-rays and bone marrow examination if the anaemia is protracted and the cause obscure.
|
