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Symptoms of iron deficiency anaemia

Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops.
You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer.
The most common symptoms include:

tiredness and lack of energy (lethargy)
shortness of breath
noticeable heartbeats (heart palpitations)
a pale complexion
Less common symptoms include:
hearing sounds that come from inside the body, rather than from an outside source (tinnitus)
an altered sense of taste
feeling itchy
a sore or abnormally smooth tongue
hair loss
a desire to eat non-food items, such as ice, paper or clay (pica)
difficulty swallowing (dysphagia)
painful open sores (ulcers) on the corners of your mouth
spoon-shaped nails

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What causes iron deficiency anaemia?

There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines.

This can be caused by a stomach ulcer, stomach cancer, bowel cancer, or by taking non-steroidal anti-inflammatory drugs (NSAIDs).

In women of reproductive age, heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy.

Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean you’re more likely to develop anaemia than if you have one of the problems mentioned above.

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Gastrointestinal Blood Loss

The gastrointestinal tract is the part of the body responsible for digesting food. It contains the stomach and intestines.
Bleeding in the gastrointestinal tract is the most common cause of iron deficiency anaemia in men, as well as women who’ve experienced the menopause (when monthly periods stop).
Most people with gastrointestinal bleeding don’t notice any obvious blood in their stools and don’t experience any changes in their bowel habits.
Some causes of gastrointestinal bleeding are described below.
Stomach Ulcers
Stomach Cancers
Bowel cancers
Malabsorptions like Coeliac, Crohn’s, Ulcerative Colitis,

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Causes of Anaemia

A wide range of health conditions and factors can cause anaemia

Gastrointestinal causes

Hemorrhoids are inflamed anal blood vessels, and they are extremely common. They can develop on the outside or inside of the anus, appearing as small bumps that occasionally bleed during bowel movements or when wiping.

Hemorrhoids, which are also referred to as piles, can impact anyone of any age but are associated with a few risk factors, including:

  • pregnancy
  • chronic constipation and straining
  • chronic diarrhea
  • straining during bowel movements or sitting on the toilet for too long
  • obesity
  • low fiber or unbalanced diet
  • aging

Hemorrhoids usually respond well to over-the-counter creams and suppositories that contain hydrocortisone. Taking warm baths frequently, eating a high-fiber diet, and using stool softeners can also help reduce the discomfort of hemorrhoids.

If initial treatments fail, a doctor may perform minor surgery to remove the hemorrhoids.

Menustral loss

In women of reproductive age, periods are the most common cause of iron deficiency anaemia.

Usually, only women with heavy periods develop iron deficiency anaemia. If you have heavy bleeding over several consecutive menstrual cycles, it’s known as menorrhagia.



It’s also very common for women to develop iron deficiency during pregnancy.

This is because your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients. 

Some pregnant women require an iron supplement, while others may need to increase the amount of iron in their diet.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in the stomach. Ibuprofen and aspirin are two commonly prescribed NSAIDs.

Chronic Kidney disease

People with chronic kidney disease (CKD) often develop iron deficiency anaemia.

Most people with CKD who have iron deficiency anaemia will be given iron supplement injections, although daily tablets may be tried first.

Other Causes

Other conditions or actions that cause blood loss and may lead to iron deficiency anaemia include:

  • inflammatory bowel disease – a condition that causes redness and swelling (inflammation) in the digestive system, such as Crohn’s disease and ulcerative colitis 
  • oesophagitis – inflammation of the gullet (oesophagus) caused by stomach acid leaking through it
  • schistosomiasis – an infection caused by parasites, mainly found in sub-Saharan Africa
  • blood donation – donating a large amount of blood may lead to anaemia
  • trauma – a serious accident, such as a car crash, may cause you to lose a large amount of blood 
  • nosebleeds – having regular nosebleeds may lead to anaemia, although this is rare
  • haematuria (blood in your urine) – but this rarely causes anaemia and may be a symptom of another condition


Malabsorption is when your body can’t absorb iron from food, and is another possible cause of iron deficiency anaemia.

This may happen if you have coeliac disease, a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy).


Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused solely by a lack of iron in your diet.

However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the conditions mentioned above.

Some studies suggest vegetarians or vegans are more at risk of iron deficiency anaemia because of the lack of meat in their diet.

If you are vegetarian or vegan, it is possible to gain enough iron by eating other types of food, such as:

  • beans
  • nuts
  • dried fruit, such as dried apricots
  • wholegrains, such as brown rice
  • fortified breakfast cereals
  • soybean flour
  • most dark-green leafy vegetables, such as watercress and curly kale


Polyps are noncancerous, abnormal growths. When polyps grow on the lining of the rectum or colon they can cause irritation, inflammation, and minor bleeding.

In many cases, a doctor will remove polyps so they can be tested for signs of cancer and to avoid the risk of them becoming cancerous.

Colon or rectal cancer

Cancer that impacts the colon or rectum can cause irritation, inflammation, and bleeding. As many as 48 percent of people with colorectal cancer have experienced rectal bleeding.

Colon cancer is a very common form of cancer and tends to progress slowly, so it is often treatable if caught early.

Rectal cancer, while far rarer than colon cancer, is also usually curable if detected and treated in time.

Some cases of colon and rectal cancer develop from initially benign polyps. All cases of gastrointestinal cancer require treatment, which usually involves a combination of chemotherapy, radiation therapy, and surgery.

Internal bleeding

Major injury to any of the gastrointestinal organs can result in internal bleeding that passes through the rectum. Severe gastrointestinal disease can also lead to internal bleeding.

Internal bleeding almost always requires hospitalization and surgery.

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Iron Deficiency Anaemia is a warning sign for a serious underlying condition like Stomach or Bowel cancer and needs thorough investigations.

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Blood tests- Coeliac serology, Iron studies



Capsule Endoscopy

CT scans

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Should you worry?

A few occasional drops or streaks of blood in the toilet, when wiping, or in the stool, is usually not a worry.

Some people may avoid talking with their doctor about rectal bleeding out of embarrassment and anxiety, even in moderate or severe cases. While rare, heavy or chronic rectal bleeding can cause serious blood loss or be a sign of an underlying condition that requires treatment.

People should see a doctor about rectal bleeding that is chronic or noticeable, abnormal growths around the anus. It is also a good idea to talk with a doctor about rectal bleeding that does not respond to home remedies.

People should seek emergency medical attention for rectal bleeding or stool that is very dark, especially if they are also vomiting or coughing up blood. It is also vital to seek immediate help for bleeding that lasts for more than a few minutes or is accompanied by other symptoms, such as severe pain, fever, or weakness.


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People may wish to talk to a doctor about gastrointestinal symptoms that may be a sign of underlying conditions, including infections, digestive conditions, or abnormal growths.

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Prevention Tips

Common prevention tips for rectal, colon, and anal bleeding include:

  • Eating a balanced diet that is high in fiber
  • Always staying hydrated
  • Not straining when going to the washroom
  • Wiping the anus gently
  • Treating chronic or prolonged constipation with over-the-counter remedies, such as stool softeners, which are available online
  • Treating chronic or prolonged diarrhea with over-the-counter remedies, such as bismuth subsalicylate, which is available online
  • Trying not to lift heavy objects unless required
  • Maintaining a healthy body weight
  • Taking long, warm baths frequently if experiencing symptoms following treatment plans set out by a doctor for related medical conditions
  • Trying to avoid spicy, rich, fatty, heavily processed, and refined foods
  • Seeing a doctor about abnormal growths in the area
  • Avoiding overuse of non-steroidal anti-inflammatory (nsaid) drugs