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Anaemia - Diagnosis and treatment
Category : Diseases
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About Anaemia:

A blood test is mandatory to confirm the diagnosis of anaemia. Anaemia is generally diagnosed in process of diagnosis of some other major illness. Blood test helps in assessing the severity of anaemia and is, thus, helpful in the treatment as well. There are various tests that can be performed to diagnose anaemia, some of the few are as follows:

 
Blood haemoglobin test (Hb%)- To know the percentage of haemoglobin in the blood.
 
Peripheral blood test - To find out the cause of anaemia.
 
Cell count (RBC, WBC, platelet) - To diagnose the different types of anaemia, pancytopenia, leukemia, etc.
 
How diagnosis can be made:
 
Blood haemoglobin test (Hb%) may show the following results:
If the haemoblobin percent in the blood report is 4-5 gm per 100ml of blood - The patient is suffering from life threatening anaemia.
 
If the haemoglobin percent in the blood report is 8-10 gm per 100 ml of blood - The patient is suffering from moderate anaemia.
 
If the haemoglobin percent in the blood report is 12-13 gm per 100 ml of blood - The patient is anaemic with complains of tiredness, exhaution and irritation.
 
 
Different types of anaemia:
 
The peripheral blood smear examinations helps to diagnose the types of anaemia, accordind to the cell shape and size.
  • Macrocytic-normochromic anaemia - Due to folate deficiency or B-12 deficiency, pernicious anaemia. 
  • Microcytic-hypochromic anaemia - It diagnoses iron deficiency anaemia, thalassemia or sideroblastic anaemia. 
  • Normocytic-normochromic anaemia -It may be due to bone marrow failure to produce appropriate amount of RBC or due to peripheral red cell destruction. It diagnosis aplastic anaemia, haemolytic anaemia, post haemrrhagic anaemia, sickle cell anaemia or chronic disease.

Treatment for different types of anaemia:

  • For iron deficiency anaemia - Iron and folic acid tablets should be given 1 or 2 tablets per day till the blood Haemoglobin percentage reaches a normal level. The iron therapy should continue for 6 months for proper gain of health and iron reserves in the body.
  • All pregnant mothers should be given iron and folic acid tablets after the first trimester to prevent anaemia. 
  • Hookworm infestations - Albendazole-400 mg should be given to deworm the patient as a one time dose. If required, a second dose can be repeated after 15 days of first dose. 
  • Piles - Blood loss and management of piles can be done, refer to my article, Diagnosis and treatment of Piles(Haemorrhoids) along with iron therapy.
 
Educating the patients:
 
It is important to spread the awareness among the patients that eating green leafy vegetables aid in increasing the Haemoglobin percentage in blood.
It should be explained to the patients that jaggery, bajra, ragi, beans, rajma, dairy products, meat and fish all will help to get rid of anaemia.
Anaemia is often associated with scurvy, a disease of the gums, which can get healed by taking vitamin C tablets. Vitamin C tablets helps in absorption of iron in the blood.
Children suffering from iron deficiency anaemia should be given iron syrups, 5 ml per day for at least 3 months.
Diet should include iron, folic acid, B-12,B-6, B-2, vitamin C, A, D, E, C. Minerals like Zinc, Calcium and protein should be supplemented in the diet for better recovery.
 
Natural means of anaemia cure:
 
There are many food supplements and fresh vegetables and fruits that can cure anaemia and bring a healthy recovery. Some of the food are as follows:
Green leafy vegetables like lettuce, spinach, fenugreek leaves, beet juice, grapes, bananas etc are rich sources of iron.
Dried raisins, almonds, honey have iron content in them.
Dairy products like milk, cheese, yoghurt are vegetarian products rich in vitaminB-12.
Other products rich in vitamin B-12 are animal meat, liver, kidney, eggs, poultry.
Peas, lentils, grams, rajma and soyabeans are rich source of proteins, vitamin-B12 and also iron, these food products should be included in the diet for better health gain.

Conclusion:

Severely ill patients with anaemia level 3-5 gm% should be hospitalized and treatment continued as blood transfusion will be required.
The patients showing symptoms of heart failure and those associated with diseases like tuberculosis should be admitted to hospital and treatment continued thereafter.
Anaemia that is not microcytic hypochromic type and the anaemia not responding to treatment even after one month of iron and folic acid therapy should be referred for hospitalization for treatment to continue further.
 
Patients who are sensitive to iron therapy and are unable to tolerate treatment should be hospitalized for blood transfusion at the earliest.
When bleeding is heavy, recurrent, and does not stop, and in cases of suspect of leukemias, thalassemias and other malignancies, the patient should be first hospitalized and treatment continued.
 
Note: 
Iron therapy in some patients may cause stomach upset, loose stools, constipation or gastric problems. In such cases, the dose should be reduced and therapy to be continued as per patient tolerance level. More water should be taken approximately minimum 2 litres per day and high fibre diet is recommended.