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Digestive Disorders

Iron Deficient Anemia

09/10/2007

Question:

Is iron deficient anemia possible with Crohn`s disease when the disease has only appeared in the terminal ileum and two resections were done years ago in the same location? The Crohn`s is currently inactive too.

I ask because I was told the resections were the reason for the anemia (Hgb 9.3 and ferritin 5) by the hematologist but the GI doctor said that was impossible as iron is not absorbed in the terminal ileum.

So who do I follow here? No one can explain the recurrent anemia despite iron effusions other than to blame it on my long history of Crohn`s. Sometimes I think my doctors blame Crohn`s for everything even though it is dormant now simply because it`s easier to do so.

Thanks for your help.

Answer:

I agree, Crohn's may be a fallback diagnosis for a lot of your problems, but unless active and bleeding, it does not account for your anemia. Most iron absorption does occur in the small bowel, but in the upper small bowel (duodenum) which may be affected by the Crohn's. If not done so already, an upper endoscopy with biopsies is probably warranted.

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Response by:

Annette  Kyprianou, MD Annette Kyprianou, MD
Senior Clinical Instructor of Medicine
School of Medicine
Case Western Reserve University