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Suggest Treatment For Iron Deficiency Anemia And Mild Asthma

Posted on Fri, 5 May 2017

Question: Hello Doc,
Hi Doc, My mom is suffering from the below sickness
1. Iron Deficiency Anemia
2. Low hemoglobin 8.5
3. Mild Asthma
4. Irritable Bowel ( she uses the washroom thrice or even 4 time s a day, very frequent, she feels fuller all the time.
Test Performed :
Endoscopy
Colonoscopy and got the biopsy done as well
human tissue transglutaminase antibody test - Repost is negative
findings :
Endoscopy :
Colonoscopy :
the Hematologist Doc has put her now on Iron Injection and the gastroenterologist has not recommended any treatment for the ulcers. Can you please advice on the same , Are these ulcers cancerous or what according to you is the treatment .

Regards,

5.

Answered by Dr. Hari Charan Perigela (30 minutes later)

Brief Answer:
I prescribe a Intestinal Antibiotic.

Detailed Answer:
Hi
I saw the reports in detail.
All these investigations were aimed at knowing the cause of Anaemia.
Upper GI endoscopy is normal.Faecal Occult blood test (FOBT)is also normal.
Colonoscopy revealed ulcers in the last portion of small intestine, i. e, Ileum.But,the biopsy report excluded Cancer,Tuberculosis.
The ulcers could be due to infection with Bacteria like Salmonella typhi which causes Typhoid etc.I prescribe an Antibiotic like Levofloxacin 250mg twice daily after food for 7 days to my patients with similar complaints.
Anaemia could be due to Iron deficiency. You can continue with Iron injections. I prefer to add a proton pump inhibitor like Rabeprazole 20mg twice daily before food to prevent ulcers in the stomach /Duodenum due to Iron therapy.
Nothing to worry.She will recover.
Hope I answered your query.If you have any questions, I will clarify further.
Wish her good health.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Hari Charan Perigela (35 minutes later)

Thank you doctor, for giving a detailed overview. This really helps.

Just a concluding question:
1. Are these Ulcers cancerous or in near future do you see any such abnormalities occurring ?
2. The Gastro has not recommended any medication for ulcers, I did not understand the reason for the same.

Answered by Dr. Hari Charan Perigela (29 minutes later)

Brief Answer:
They are not cancerous.

Detailed Answer:
Hi
1.Ulcers in the terminal ileum are not cancerous as per Biopsy report. Chances of Cancer at that site are very very rare.
2.We see cases of Ulcers in stomach,Duodenum,Colon.Very rarely, ulcers are seen in the terminal ileum.I prefer to add an Antibiotic instead of waiting for the ulcers to resolve spontaneously.I saw many cases of Typhoid ulcers in terminal ileum.So,I prefer Antibiotic therapy.
Hope I answered your query.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Hari Charan Perigela (42 minutes later)

Thank you doctor. I will put her on Levofloxacin 250mg twice daily after food for 7 days .

Thanks .

Regards,
xxxxxx

Answered by Dr. Hari Charan Perigela (1 minute later)

Brief Answer:
Thank you for the response

Detailed Answer:
Hi
Thank you for the response.
Wish her speedy recovery.
Regards

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj