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| Anemia, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Lack of blood or anemia is a condition when the body lacks healthy red blood cells or when red blood cells do not function properly. As a result, the organs of the body do not get enough oxygen, making people with anemia pale and tired easily.
Anemia can occur temporarily or in the long term with a severity of mild to severe. Anemia is a blood disorder or hematological disorder that occurs when the level of hemoglobin (the main part of red blood cells that binds oxygen) is below normal.
An adult is said to be anemic if the hemoglobin level is below 14 grams per deciliter for men and less than 12 grams per deciliter for women. Anemia with hemoglobin levels below 8 grams per deciliter is considered severe. This condition is known as anemia gravis.
Treatment of anemia depends on the underlying cause, ranging from taking iron supplements, blood transfusions, to surgery.
Causes of Anemia
Anemia occurs when the body lacks healthy red blood cells or hemoglobin. As a result, the cells in the body do not get enough oxygen and do not function normally (hypoxemia).
Broadly speaking, anemia occurs due to the following three conditions:
- Insufficient production of red blood cells
- Excessive blood loss
- The destruction of red blood cells that are too fast
The following are the types of anemia that commonly occur based on the cause:
1. Anemia due to iron deficiency
Lack of iron makes the body unable to produce hemoglobin (Hb). This condition can occur due to a lack of iron intake in the diet, or because the body is unable to absorb iron, for example due to celiac disease.
2. Anemia during pregnancy
Pregnant women have lower hemoglobin values, but this is normal. However, the need for hemoglobin increases during pregnancy so that more hemoglobin-forming substances are needed, namely iron, vitamin B12, and folic acid. If the intake of these three nutrients is lacking, anemia can occur which can harm pregnant women and fetuses.
3. Anemia due to bleeding
Anemia can be caused by heavy bleeding that occurs slowly over a long period of time or occurs suddenly. The cause can be injury, menstrual disorders, hemorrhoids, inflammation of the stomach, colon cancer, or side effects of drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs).
Anemia due to bleeding can also be a symptom of intestinal worms due to hookworm infection that sucks blood from the intestinal wall.
4. Aplastic anemia
Aplastic anemia occurs when damage to the bone marrow makes the body no longer able to produce red blood cells optimally. This condition is thought to be triggered by infections, autoimmune diseases, exposure to toxic chemicals, and the side effects of antibiotics and drugs to treat rheumatoid arthritis.
5. Hemolytic anemia
Hemolytic anemia occurs when red blood cells are destroyed faster than they are made. This condition can be inherited from parents, or acquired after birth due to blood cancer, bacterial or viral infections, autoimmune diseases, and side effects of drugs, such as paracetamol, penicillin, and antimalarial drugs.
6. Anemia due to chronic disease
Some diseases can affect the process of red blood cell formation, especially if it lasts for a long time. Some of these include Crohn's disease, kidney disease, cancer, rheumatoid arthritis, and HIV/AIDS.
7. Sickle cell anemia
Sickle cell anemia is caused by a genetic mutation (change) in hemoglobin. As a result, hemoglobin becomes sticky and abnormally shaped, which is like a crescent moon. A person can develop sickle cell anemia if both parents have this genetic mutation.
8. Thalassemia
Thalassemia is caused by a gene mutation that affects the production of hemoglobin. A person can suffer from thalassemia if one or both parents have the same condition.
Symptoms of Anemia
Symptoms of anemia vary widely, depending on the cause. People with anemia may experience symptoms such as:
- Weak and tired
- Headaches and dizziness
- Often sleepy, for example sleepy after eating
- Skin looks pale or yellowish
- Irregular heartbeat
- Short breath
- Chest pain
- Cold in hands and feet
The above symptoms are often not recognized by the patient at first, but will be felt more and more as the anemia condition gets worse.
When to go to the doctor
Check with your doctor if you feel tired quickly or experience symptoms of anemia that are getting worse over time. If you suffer from anemia that requires long-term treatment or even regularly receives blood transfusions, then do regular check-ups with your doctor to monitor the progress of the disease.
Consult a doctor if you have conditions that can cause anemia, such as kidney disease, menstrual disorders, colon cancer, or hemorrhoids.
For pregnant women, decreased Hb is normal. To maintain the health of the mother and fetus, check your pregnancy regularly to the obstetrician. The obstetrician will provide supplements to prevent anemia during pregnancy. If you suffer from genetic disorders that can cause anemia, such as thalassemia, or have a family who suffers from the disease, it is advisable to consult a doctor before planning to have children.
Anemia Diagnosis
To determine whether the patient is anemic, the doctor will perform a complete blood count. Through a blood test, the doctor will measure the levels of iron, hematocrit, vitamin B12, and folic acid in the blood, as well as check kidney function. The purpose of the test is to determine the cause of anemia.
In addition to blood tests, the doctor will perform other follow-up tests to look for causes of anemia, such as:
- Endoscopy, to see if the stomach or intestines are bleeding
- Pelvic ultrasound, to determine the cause of menstrual disorders that cause anemia
- Bone marrow aspiration examination, to determine the level, shape, and maturity level of blood cells from the 'factory' directly
- Examination of amniotic fluid samples during pregnancy to determine the possibility of the fetus suffering from genetic disorders that cause anemia
Anemia Treatment
The method of treating anemia depends on the type of anemia the patient has. Please note, treatment for one type of anemia can be dangerous for other types of anemia. Therefore, doctors will not start treatment until they know the exact cause.
Some examples of anemia treatment or blood deficiency drugs by type are:
• Anemia due to iron deficiency
This condition is overcome by consuming food and iron supplements. In severe cases, blood transfusion is required.
• Anemia during pregnancy
This condition is treated with iron, folic acid, and vitamin B12 supplements, the dosages of which are determined by the doctor.
• Anemia due to bleeding
This condition is treated by stopping the bleeding. If needed, the doctor will also provide iron supplements or blood transfusions.
• Aplastic anemia
Treatment is with blood transfusions to increase the number of red blood cells, or a bone marrow transplant (graft) when the patient's bone marrow can no longer produce healthy red blood cells.
• Hemolytic anemia
Treatment is by stopping the consumption of drugs that trigger hemolytic anemia, treating infections, taking immunosuppressant drugs, or removing the spleen.
• Anemia due to chronic disease
This condition is treated by treating the underlying disease. In certain conditions, blood transfusions and injections of the hormone erythropoietin are needed to increase the production of red blood cells.
• Sickle cell anemia
This condition is treated with iron and folic acid supplements, bone marrow grafts, and chemotherapy, such as hydroxyurea. In certain conditions, the doctor will give painkillers and antibiotics.
• Thalassemia
In treating thalassemia, doctors can perform blood transfusions, giving folic acid supplements, removal of the spleen, and bone marrow grafts.
Complications of Anemia
If left untreated, anemia is at risk for serious complications, such as:
- Difficulty doing activities due to fatigue
- Heart problems, such as heart rhythm disturbances (arrhythmias) and heart failure
- Lung disorders, such as pulmonary hypertension
- Pregnancy complications, including premature birth or low birth weight baby
- Impaired growth and development if anemia occurs in children or infants
- Vulnerable to infection
Anemia Prevention
Some types of anemia, such as anemia during pregnancy and anemia due to iron deficiency, can be prevented by eating a diet rich in nutrients, especially:
- Foods rich in iron and folic acid, such as meat, cereals, beans, dark green leafy vegetables, breads, and fruits
- Foods rich in vitamin B12, such as milk and its derivatives, as well as soy-based foods, such as tempeh and tofu
- Fruits rich in vitamin C, such as oranges, melons, tomatoes and strawberries
In addition to food, anemia due to iron deficiency can also be prevented by taking iron supplements regularly.
Normal Hb levels for each person are different, depending on age and gender. The following is the range of normal Hb values:
- Adult males: 13 g/dL (grams per deciliter)
- Adult women: 12 g/dL
- Pregnant women: 11 g/dL.
- Infants: 11 g/dL
- Children aged 1–6 years: 11.5 g/dL
- Children and adolescents ages 6-18 years: 12 g/dL
To find out if your nutritional intake is sufficient, discuss it with a nutritionist. If your family suffers from anemia due to genetic disorders, such as sickle cell anemia or thalassemia, consult your doctor before planning a pregnancy so that this condition does not occur in children.
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