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—
- a) Macrocytic (large cells) – seen in vitamin B12 & folic acid deficiency.
- b) Normocytic (normal size of cells) – seen in recent blood loss, aplastic anaemia
- c) Microcytic (small cells) and less circulating haemoglobin, as in iron deficiency anaemia and thalassemia.
- 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.
- 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 –
- Inadequate dietary intake secondary to a poor diet without supplementation.
- Inadequate absorption resulting from diarrhoea, acidity, intestinal disease such as celiac disease, atrophic gastritis, partial or total gastrectomy, or drug interference.
- Inadequate utilization secondary to chronic gastrointestinal disturbances.
- Increased iron requirement for growth of blood volume, which occurs during infancy, adolescence, pregnancy, and lactation and which isnot being matched with intake.
- 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.
- 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 –
- 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.
- 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.
- 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.