Dear Pouchers,

I thought some of you might find this interesting. Please confirm this information with your own research!

Since getting an internal pouch I have dealt with anemia to varying degrees, including the transfusion of 2 units last year after nearly passing out in a grocery store. While visiting the Cleveland Clinic last week, a GI who works with Dr. Fazio, shared that the Clinic just published a study investigating Anemia and Pouches. What I remember him telling me, (please investigate this on your own), is that 25% of people with internal pouches are found to be anemic. And, 25% of those with this anemia, the reason for it is never found. (So far, I lie in that 25% of 25%, again...no answers). I thought this important to share, as it helped me to explain my lack of energy since getting a pouch, both j and k. PLEASE, investigate this informaiton on your own, as this was a short, quick conversation with the Doc.

Joe

I read the abstract of this study you're talking about. Pretty interesting.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed...&itool=pubmed_docsum

Oh, and if you're talking about Dr Shen (he is my GI too) I have always found him very ready to answer all my questions. He has even told me himself I could email him, which I highly recommend you do if you still have some concerns/questions. His email is on his business card. I usually get a response the same day unless he is away from the Clinic.

I hope that your pouch function improves and you can keep the K-pouch.

--
katie

Hi,

I too suffer from anemia. I just had blood work done and my HG Count is 10 which I think is moderate anemia.

If the anemia is due to having a j-pouch/chronic illness do the iron supplements work? Or are there other therapies that need to be used to treat the anemia?

Right now the fatigue is really hard to deal with and I am trying to find some relief.

You are in the Kock pouch section. If oral iron isn't working for you...they can give you IV treatments of Ferritin.

iron supplements may work but for some people they can cause cramping and constipation. I for one cannot take them.

The information below was mailed to the BCIR alumni who had their pouches constructed at Palms of Pasadena Hospital in St. Petersburg, FL. I went over to their website and cut and pasted. Please take it for what it is worth. Just trying to help. Ellen

Conf: General BCIR Discussion
From: Susan Kay susan.kay@bcirostomy.com
Date: Thursday, September 14, 2006 02:01 PM

To maintain wellness, we want our BCIR alumni and their health care team to be aware of the possibility of anemia. The two major etiologies of anemia in this patient population are related to low Iron Stores and B12. Early diagnosis and prompt treatment can limit the severity of these conditions.

Iron Deficiency Anemia

Each time you intubate your pouch, microscopic blood is lost. In time, the cumulative effect can catch up with you with the symptoms of weakness and fatigue. In more severe cases one can complain of shortness a breath and dizziness.

It is our recommendation that your PCP monitor your Ferritin level every 3 – 4 months as a standard blood test. A normal Ferritin level is different in each lab so understanding the reference range is necessary. We would like you to stay on the upper spectrum of the grid. We suggest intravenous iron transfusions when and if the trend is decreasing. Do not wait for the level to drop significantly before you seek intervention. Again we want you to stay on the upper end of this level. Usually a hematologist is the specialist who would administer the intravenous Iron in an out patient setting. Once your iron stores are normal continue to have your Ferritin levels followed every 4 months and react accordingly. The goal is to be proactive and not reactive. We do not suggest oral iron routinely as the absorbency is questionable and it is difficult on the stomach.

B12 Deficiency

Vitamin B12 is essential for normal nervous system function and blood cell production. There are several causes for this type of deficiency but one is intestinal surgery that may affect absorption. Therefore it is our desire for you to get a B12 level at least twice a year. Treatment would be vitamin B12 injections until the condition improves.