Understanding the Connection Between Anemia and Gastrointestinal Bleeding

Rebekah Kuschmider
Rebekah Kuschmider
September 12, 2024
7
min read
Medically reviewed by:
Trager Hintze, PharmD
Understanding the Connection Between Anemia and Gastrointestinal Bleeding
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Gastrointestinal health can have a significant impact on your overall health and well-being. Issues such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn’s disease, and celiac disease can cause stomach pain, bloating, constipation, or diarrhea.   

Chronic GI conditions can also cause gastrointestinal bleeding. Blood loss from GI bleeding can result in iron deficiency anemia, a condition that leads to fatigue, weakness, and overall malaise.

What Is Iron Deficiency Anemia? 

Iron-deficiency anemia is a type of anemia that develops when you don’t have sufficient iron in your body [1].

Iron is a vital nutrient that your body needs for proper blood circulation. Iron supports two important circulatory functions:

  • Hemoglobin Production. Iron is crucial for hemoglobin production. Hemoglobin is the protein in red blood cells (RBCs) that carries oxygen. Without enough iron, your body can’t produce as many red blood cells, and red blood cells can become smaller or paler, causing microcytic and hypochromic anemia respectively. 
  • Oxygen Transport. Red blood cells are necessary for getting oxygen to all the other cells in your body. Compromised hemoglobin levels result in too little oxygen in the bloodstream and not enough oxygen reaching the rest of the body. 

The human body does not produce iron, so you need to ingest it from dietary sources. It’s present in  many foods, including:

  • Red meats
  • Beans 
  • Eggs
  • Salmon
  • Iron-fortified breads and cereals
  • Tofu
  • Dark leafy greens

Insufficient iron levels can be a result of dietary imbalances, but underlying health issues can also affect iron levels. It is possible to have iron deficiency without anemia. 

Foods rich in iron that can help with anemia include red meat, spinach, lentils, and fortified cereals.

Symptoms of Iron Deficiency Anemia

The symptoms of iron-deficiency anemia may be ambiguous. Since iron-deficiency anemia causes decreased amounts of oxygen to circulate in the body, symptoms are generalized and often include ambiguous issues like fatigue, which can be easily attributed to other causes. 

Common symptoms of iron-deficiency anemia include [2]: 

  • Pale or sallow skin coloration
  • Fatigue or lack of energy
  • Generalized weakness
  • Shortness of breath or chest pain
  • Increased heart rate
  • Pounding or whooshing sound in the ears
  • Headaches
  • Sore or smooth tongue
  • Brittle nails or hair loss
  • Anemia rash, or itchy red bumps called petechiae
  • Skin bruising
  • Unusual food cravings such as craving ice or clay

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Causes of Iron Deficiency Anemia

Iron deficiency is a common condition, either due to diet or health issues. 

Chronic Blood Loss

Health conditions that cause chronic internal bleeding can lead to anemia. Anemia and GI issues are often linked because gastrointestinal bleeding is a common source of chronic blood loss, especially among older adults. Conditions that can cause gastrointestinal bleeding and anemia include [2]:

  • Gastritis, an inflammation of the stomach 
  • Esophagitis, an inflammation of the esophagus 
  • Bleeding ulcers 
  • Angiodysplasia, which causes blood vessels in the GI tract to swell and leak
  • Acute GI conditions such as infections like diverticulitis or colorectal cancer

Kidney disease can also cause chronic blood loss and iron-deficiency anemia.

Iron-Poor Diet

Individuals who follow a vegan or vegetarian diet may be at increased risk of iron-deficiency anemia if they aren’t careful to consume food with sufficient iron [2].

Reproductive Health Issues

Anemia is also common during pregnancy and after childbirth. Heavy menstrual periods and endometriosis can also lead to iron deficiency anemia [2]. 

Absorption Issues

If your body can’t absorb enough iron from your diet, you can develop anemia [3]. Conditions that affect the way your GI tract functions, such as celiac disease, Crohn’s disease, or inflammatory bowel disease (IBD), can limit iron absorption. People with a history of bariatric surgery are also at risk for anemia linked to poor iron absorption. 

Medications 

Certain medications, particularly medications that treat conditions like gastroesophageal reflux disease (GERD), can inhibit iron absorption. Proton-pump inhibitors, histamine-2 receptor antagonists, and calcium carbonate have all been linked to iron deficiency anemia [4]. Certain antibiotics and blood pressure medications may also reduce iron absorption [5]. 

Iron deficiency anemia is caused by chronic blood loss, poor diet, absorption issues, or medications that interfere with iron absorption.

At-Home Testing With Colonox-FIT

One sign of gastrointestinal bleeding is the presence of blood in stools. Not all fecal blood is visible, however, making it challenging to identify the presence of blood. The Colonox-FIT test detects the presence of blood that can’t be seen, also known as fecal occult blood. 

The Colonox-FIT test is an at-home version of the same fecal immunochemical test that healthcare providers use to screen for signs of gastrointestinal issues. The easy-to-use test uses antibodies to measure hemoglobin proteins in the stool in under 10 minutes. 

Testing for fecal occult blood can alert you to potential health issues, including GI bleeding that causes iron deficiency anemia. The Colonox-FIT doesn’t specifically test for anemia at home, but it can be one indicator that you may be at risk for anemia. 

If you suspect you have iron-deficiency anemia or GI bleeding, contact your doctor right away so you can get appropriate treatment. 

References

[1] National Heart Lung and Blood Institute, “Iron-Deficiency Anemia.” [Accessed September 5, 2024.]

[2] American Society of Hematology, “Iron-Deficiency Anemia.” [Accessed September 5, 2024.]

[3] J. L. Harper, “Iron Deficiency Anemia,” Medscape, 2023. [Accessed September 5, 2024.]

[4] R. D. Vinnakota and A. S. Brett, "Iron Deficiency Anemia Associated With Acid-Modifying Medications: Two Cases and Literature Review," The American Journal of the Medical Sciences, vol. 357, no. 2, pp. 160–163, February 2019.

[5] St. Luke’s Hospital, “Possible Interactions with Iron.” [Accessed September 5, 2024.]

About the Author
Rebekah Kuschmider

Rebekah has been writing about culture, health, and politics since 2010. She has a masters degree in Arts Policy and Administration from The Ohio State University. Her work has been seen at WebMD, The Candidly, MedicineNet, YourTango, Ravishly, Babble, Scary Mommy, Salon, Role Reboot, The Good Men Project, SheSaid, Huffington Post, and Mamamia. She is a former cohost of the weekly podcast The More Perfect Union. Rebekah lives in Maryland with her husband, two kids, and a dog who sheds a lot.

About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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