Anemia and Women’s Health, Anaemia is a deficiency in the size or number of red blood cells

(RBCs) or the amount of haemoglobin they contain.

Anaemia classification is based on :-

* Cell size—

  1. a) Macrocytic (large cells) – seen in vitamin B12 & folic acid deficiency.
  2. b) Normocytic (normal size of cells) – seen in recent blood loss, aplastic anaemia
  3. c) Microcytic (small cells) and less circulating haemoglobin, as in iron deficiency anaemia and thalassemia.

* Haemoglobin content

  1. a) Hypochromic (pale colour due to deficiency of haemoglobin) – seen in iron deficiency, chronic blood loss. It is treated with ferrous sulphate & correction of cause.
  2. b) Normochromic (normal colour) – seen in recent blood loss, haemolytic diseases. It is treated with transfusion, iron & correction of cause.

Anemia and Women’s Health,

Nutritional anaemia is caused by a lack of or inadequate intake of nutrients required for normal synthesis of RBCs, principally iron, vitamin B12, and folic acid.

Causes of Iron deficiency anaemia –

  1. Inadequate dietary intake secondary to a poor diet without supplementation.
  2. Inadequate absorption resulting from diarrhoea, acidity, intestinal disease such as celiac disease, atrophic gastritis, partial or total gastrectomy, or drug interference.
  3. Inadequate utilization secondary to chronic gastrointestinal disturbances.
  4. Increased iron requirement for growth of blood volume, which occurs during infancy, adolescence, pregnancy, and lactation and which isnot being matched with intake.
  5. Increased excretion because of excessive menstrual blood (in females); haemorrhage from injury; or chronic blood loss from a bleeding ulcer, bleeding haemorrhoids, oesophageal varices, parasitic ormalignant disease.
  6. Increased destruction of iron from iron stores into the plasma and defective iron use caused by a chronic inflammatory disorder.

Clinical findings and symptoms of anemia –

Early

  • Fatigue, anorexia, and pica
  • Inadequate muscle function
  • Growth abnormalities
  • Reduced immune-competence lead to frequent infections.
  • Epithelial disorders of the tongue, nails, mouth, and stomach.
  • Skin may appear pale; inside of the lower eyelid may be light pink instead of red.

Late

  • Defects in epithelial tissues -Mouth changes include atrophy of the lingual papillae, burning, redness, and in severe cases a completely smooth, waxy, and glistening appearance of the tongue (glossitis) and angularstomatitis. Fingernails (spoon-shaped nails) can become thin and flat.
  • Gastritis
  • Cardiac failure
  • Medical management of anemia–
  • Assess for and treat underlying disease
  • Oral iron salts
  • Oral iron, chelated with amino acids
  • Oral sustained release iron
  • Iron-dextran by parenteral administration
  • Nutrition management of anemia–
  • Increase absorbable iron in diet -Liver, kidney, beef, dried fruits, dried peas and beans, nuts, dark green leafy vegetables, fortified whole-grain breads, cereals, are among the foods that rank highest in iron content.
  • Include vitamin C at every meal (lime, oranges, guava, amla) as vitamin C binds iron to form a readily absorbed complex.
  • Include meat, fish, or poultry at every meal.
  • Decrease tea and coffee consumption- If taken with meals, tea and coffee can reduce iron absorption by 50% through the formation of insoluble ironcompounds with tannin.

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