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What Causes Low Hemoglobin And Blood Discharge While Defecating?

Posted on Wed, 14 May 2014

Question: hi doctor good evening . I am R.P. XXXXXXX age 59 yrs Male from Meerut UP(India). My Hb going down repeatedly. last year Hb gone down to 5 and I was given iron supplements then my Hb rise to 9.3 in three months. Again my Hb gone down to 5 in Jan2014. All blood tests can be seen in attatched file 'myhealth' marked scan to scan16. After my blood report (marked scan) Dr. XXXXXXX advise me to take Livigen-z tds and folvit bd(scan2). Then after I met Dr. XXXXXXX at Jamshedpur and he advised for various tests(scan3 to scan9) and advised to continue the ;previous medicines. I met Dr. Mandal at Ranchi on 27/01/2014. he advised me the medicines Cap Conviron-Forte BD, Tab Nexpro-40 BD, Softvac 2tsf with 100ml water, Tab 1wral-brte 1 daily for 3days, cap A to Z -gold 1 cap daily and advised tests(scan10 to scan14). On 04/02/14 dr. mandal added the medicines cap uprose-d3 1cap daily for 3 days and the a cap once in a week, Cap ME-12 OD for 2 months. My hb dated 25/02/2014 was 8.3 and gone down to 7.8 on 18/04/2014. Kindly advice the suitable medicine so that Hb should go to normal level and remain constant.It is for your kind information that I am in habit of smoking cigarrete use to take nearly 15 in a day. Thanks.

Answered by Dr. Rakesh Madhyastha (12 hours later)

Brief Answer:
Insufficient work up of the case

Detailed Answer:
Hello

Thanks for the query

I really appreciate your effort in uploading the scans, I have gone through them in detail. Here are my interpretations

1. Your Serum iron is very low. It means that the the total iron stores in the your body is critically low, I strongly advice you to replenish it with IV Iron injections, Tablets are not sufficient to replenish them
2. Your stools for occult blood is positive. It means that there is loss of blood in while you are passing motion. I recommend that you get an Endoscopy done in order to rule out ulcer in the stomach which might be causing constant drop in your Hb
3. I also recommend that you get Vit B 12 levels, as your peripheral smear shows macrocytes.

Since I am suspecting ulcer in the stomach which is causing the fall in Hb, please refrain from smoking as it might aggravate the situation.

I hope I was of help, if you have any further queries please get back to me

I wish you good health and a speedy recovery

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (36 hours later)

Reports sent

Answered by Dr. Rakesh Madhyastha (31 hours later)

Brief Answer:
Hello

Detailed Answer:
Thanks once again for getting back to me, I am sorry for the short delay in my reply I was on call at my hospital

Here are my interpretations

1. Your Heamoglobin is low and it is due to iron deficiency as your PCV is also low. Please re check your Iron load, IV ( intra venous) iron is the best solution for you.
2. Stool for occult blood is now negative which is good news
3.Please get the tests I have recommended previously and I also recommend that you get Complete blood count next time not just Hb

I hope I was of help

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar