Constipation And Anemia: What's The Link?

Constipation is not a symptom of anemia. However, constipation may be related to the cause of anemia or its treatment. For example, oral iron supplements, which are the most common treatment for iron deficiency anemia, may cause or worsen constipation.

Iron deficiency and constipation

Iron deficiency is not known to cause constipation. However, constipation could be a symptom of an underlying condition that is causing your anemia.

Iron deficiency anemia is the most common type of anemia, affecting around 2% of men and between 9% and 20% of women. It is caused by a lack of red blood cells or hemoglobin, which can occur due to vitamin and nutrient deficiencies, immune system problems, and long-term chronic diseases.

If left untreated, iron deficiency anemia can lead to various complications, including heart issues. In its early stages, anemia may not cause any noticeable symptoms, but over time, it can significantly decrease your quality of life. Some people with anemia report developing constipation.

While constipation is not a direct symptom of iron deficiency anemia, it can be related to the underlying cause of the condition or its treatment. For example, untreated Crohn's disease or irritable bowel syndrome can lead to both constipation and anemia. Additionally, oral iron supplements used to treat iron deficiency can cause gastrointestinal side effects, such as nausea, abdominal pain, and constipation.

If you are experiencing symptoms of anemia, such as dizziness, fatigue, and chest pain, along with constipation, it is important to consult a medical professional. They can refer you to a gastroenterologist who can run appropriate tests and diagnose any underlying conditions that could be causing both the anemia and constipation.

Underlying digestive issues

While constipation is not a symptom of anemia, it can be related to the cause of the condition or a side effect of the treatment. People who experience both constipation and anemia are likely to have underlying digestive tract issues.

Celiac disease

Celiac disease is an autoimmune condition that damages the inner lining of the small intestine. Exposure to gluten triggers flare-ups of inflammation that damage the villi—tiny projections that line the inner wall of the small intestine. When villi are damaged, the body cannot properly absorb nutrients, including minerals like iron, from food.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) includes two conditions: Crohn's disease and ulcerative colitis. IBD causes inflammation and ulcers in the digestive tract. Ulcers bleed, leading to iron deficiency. The condition can also make it difficult for the body to replace iron. Nutrient malabsorption, including that of iron, can occur due to damage to the gut.

Diverticulitis

Diverticulitis is a common condition where small sac-like pouches form in the lining of the colon and become inflamed. The inflammation can cause intestinal bleeding that leads to iron-deficiency anemia about 25% of the time.

Hiatal hernia

A hiatal hernia occurs when the upper part of the stomach bulges through the large muscle that separates the abdomen and chest. If the piece of the stomach is large enough, it can cause food and acid to back up into the esophagus, leading to heartburn and sores that result in invisible, ongoing blood loss. This raises the risk of iron-deficiency anemia.

Heartburn medication

Heartburn itself does not cause anemia, but proton-pump inhibitors (PPIs)—a common medication for heartburn—can block iron absorption and lead to iron deficiency over time.

Bariatric or weight loss surgery

Iron-deficiency anemia is much more common after gastric bypass surgery than other weight loss procedures. After this surgery, food bypasses the part of the small intestine that absorbs iron from food.

Stomach ulcers

Stomach ulcers are open sores usually caused by acid. Many people with stomach ulcers do not have any symptoms. However, ulcers can bleed slowly over time, leading to anemia. Faster bleeding often shows up in stool, which may appear jet black, sticky, or with streaks of blood.

If you are experiencing symptoms of anemia and constipation, it is important to consult a medical professional. They can refer you to a gastroenterologist who can run appropriate tests and diagnose any underlying conditions.

Pregnancy and iron deficiency

During pregnancy, the volume of blood increases, and so does the need for iron and vitamins to make more red blood cells. Iron deficiency anemia is the most common type of anemia in pregnancy. It occurs when the body doesn't have enough iron stores to create red blood cells for the baby's growth and development, especially in the last three months of pregnancy.

Risk Factors

Women are more likely to experience iron-deficiency anemia during pregnancy if they:

• Have two pregnancies close together.
• Are pregnant with multiples (twins, triplets, etc.).
• Experience frequent vomiting due to morning sickness.
• Do not consume enough iron through their diet and prenatal vitamins.
• Had heavy periods before pregnancy.

Prevention and Treatment

Good nutrition before and during pregnancy is crucial for preventing iron-deficiency anemia. Eating a healthy, balanced diet can help maintain iron levels and ensure the baby's healthy growth.

Food sources rich in iron include:

• Meats: Beef, pork, lamb, liver, and other organ meats.
• Poultry: Chicken, duck, turkey, and liver, especially dark meat.
• Fish and shellfish: Clams, mussels, oysters, sardines, and anchovies.
• Leafy greens: Broccoli, kale, turnip greens, and collards.
• Legumes: Lima beans, green peas, and dried beans (e.g., pinto beans, black-eyed peas).
• Fortified grains: Iron-enriched white bread, pasta, rice, and cereals.

In addition to a balanced diet, prenatal vitamins containing iron and folic acid are usually recommended to prevent and treat iron-deficiency anemia during pregnancy. If the condition is severe, healthcare providers may prescribe extra iron supplements.

It is important to note that taking iron supplements with dairy products or calcium supplements may hinder iron absorption. Consuming iron with citrus juice, on the other hand, can enhance its absorption.

Complications

If left untreated, iron-deficiency anemia during pregnancy may lead to potential complications, including:

• The baby may not grow to a healthy weight.
• Premature birth or low birth weight.
• Prolonged recovery period for the mother after birth due to extreme fatigue.

Menstruation and iron deficiency

People who menstruate are disproportionately affected by anemia due to the fact that they lose blood through their periods. When blood is lost every month during menstruation, the iron within those red blood cells is also lost. If monthly iron intake and absorption do not replace the iron lost during a period, this can result in iron deficiency anemia.

Heavy menstrual bleeding, also known as menorrhagia, affects 1 in 5 women in the United States each year. When someone loses a lot of blood during their period, they may end up losing more red blood cells than their body can replace. This can reduce the amount of iron in their body, making it harder for their body to make the hemoglobin needed to carry oxygen throughout their body.

Iron deficiency anemia is more common among women than men. Risk factors for women include a diet too low in iron, vitamin B12, and folate, as well as health conditions such as malabsorption disorders, chronic conditions, and genetic diseases.

The symptoms of iron deficiency anemia include tiredness, weakness, shortness of breath, poor concentration, lightheadedness, cold intolerance, and heart palpitations. Other physical signs include paleness (particularly on the inner eyelids), hair loss, chapping at the corners of the mouth, nail changes, and poor circulation (cold fingers and toes).

To prevent iron deficiency anemia caused by heavy menstrual bleeding, it is recommended to eat foods that are good sources of iron, such as red meat, spinach, legumes, shellfish, turkey, and quinoa. It is also beneficial to eat foods that help with iron absorption, like vitamin C-rich foods, as this vitamin aids the body in absorbing iron. Examples of vitamin C-rich foods include guavas, kiwis, broccoli, Brussels sprouts, lemons, strawberries, oranges, and kale.

In severe cases of iron deficiency anemia caused by heavy menstrual bleeding, surgery may be required. This could include uterine artery embolization, focused ultrasound surgery, endometrial ablation, or a hysterectomy.

Diet and iron deficiency

Diet plays a crucial role in iron deficiency, which is the most common type of anaemia. Iron deficiency occurs when the body's iron stores are too low, and this can be due to a variety of factors, including inadequate dietary intake, chronic blood loss, pregnancy, and vigorous exercise.

To prevent and treat iron deficiency, it is important to include iron-rich foods in your diet. Heme iron, found in animal tissue such as red meat, poultry, and seafood, is easily absorbed by the body. Non-heme iron, found in plant foods and some animal products, is also important but may be absorbed at lower rates. Good sources of non-heme iron include beans, green leafy vegetables, iron-fortified cereals, bread, and pasta.

In addition to increasing iron-rich foods, it is beneficial to consume foods that enhance iron absorption. Vitamin C, found in fruits and vegetables, improves iron absorption. Including animal protein with plant sources of iron can also boost absorption. Cooking plant sources of iron can increase the amount of available non-heme iron; for example, the body absorbs 30% of the iron from cooked broccoli compared to only 6% from raw broccoli.

On the other hand, certain foods and compounds can inhibit iron absorption. Calcium, tea, coffee, wine, soy proteins, and high amounts of fibre can reduce the body's ability to absorb iron. Therefore, it is recommended to avoid consuming large amounts of these foods or compounds alongside iron-rich meals.

It is important to note that the recommended daily allowance (RDA) of iron varies depending on age, sex, and life stage. For example, a male aged 19-50 years requires 8 mg of iron per day, while a female in the same age range needs 18 mg. During pregnancy, the daily iron intake should be increased to 27 mg. Consulting with a healthcare professional can help determine the appropriate iron intake and the best dietary sources for an individual's specific needs.

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