What Is Anemia?

Anemia is a condition when the body lacks blood cells containing hemoglobin to spread oxygen to all organs of the body. Under these conditions, the patient will usually feel tired, so can't perform activities optimally. Anemia can occur in both short and long periods, with mild to severe severity. Treatment of this condition varies depending on the cause. Anemia can be treated by taking supplements regularly or special treatment procedures.

Symptoms of Anemia
Anemia can be identified from the following symptoms:
  • The body feels weak and tired quickly.
  • The skin looks pale or yellowish.
  • Irregular heartbeat.
  • Shortness of breath.
  • Dizzy and dizzy.
  • Chest pain.
  • The hands and feet feel cold.
  • Headache.
  • Difficult to Concentrate.
  • Insomnia .
  • Foot cramps.
Initially, anemia symptoms are often not recognized by the patient. Anemia symptoms will be felt more if the condition suffered worse. Consultation to the doctor should be done if someone often feel tired for no apparent reason.

Causes of Anemia
Anemia occurs when the body lacks healthy red blood cells that contain hemoglobin. There are about 400 conditions that can cause anemia in a person and divided into 3 groups, namely:
  • The body does not produce enough red blood cells.
  • Bleeding causes the body to lose blood faster than the body's ability to produce blood.
  • Abnormalities in the body's reaction by destroying healthy red blood cells.
The following is a brief description of the types of anemia based on its causes, including:
  • Anemia due to iron deficiency. This type of anemia is the most common worldwide. Iron deficiency can cause the body to become anemic because the bone marrow requires iron to make blood cells. Anemia can occur in pregnant women who do not take iron supplements . Anemia can also occur in many menstrual bleeding, organ ulcers (wounds), cancer, and the use of painkillers such as aspirin. The symptoms commonly experienced by anemia sufferers of iron deficiency are:
    • Having an appetite for strange objects such as paper, paint or ice (this condition is called pica ).
    • The mouth felt dry and cracked in the corner.
    • Upward -curved nails (koilonychia).
  • Anemia due to vitamin deficiency. In addition to requiring iron, the body also needs vitamin B12 and folic acid to make red blood cells. Lack of two elements of these nutrients can cause the body can not produce healthy red blood cells in sufficient quantities resulting in anemia. In some cases, gastric anemia sufferers can not absorb vitamin B12 from digested food. The condition is called pernicious anemia. The symptoms commonly experienced by anemia sufferers deficient in vitamin B-12 and folic acid are:
    • Tingle in the hands and feet.
    • Loss of sensitivity to the sense of touch.
    • Difficult to walk.
    • Have stiffness in the legs and hands.
    • Experiencing dementia.
  • Anemia due to chronic disease. A number of diseases can cause anemia due to interference in the formation and destruction of red blood cells. Examples of such diseases are HIV / AIDS, cancer, rheumatoid arthritis , kidney disease , Crohn's disease , and chronic inflammatory diseases. The symptoms that can arise in cases of anemia due to chronic diseases include:
    • The color of the eyes and skin becomes yellowish.
    • The color of the urine turns red or brown.
    • Ulcers on the feet.
    • Symptoms of gallstones .
    • Developmental delays in children.
  • Aplastic anemia. Aplastic anemia is a rare condition that occurs but is harmful to the patient's life. In aplastic anemia, the body is unable to produce red blood cells optimally. Aplastic anemia can be caused by infection, drug side effects, autoimmune disease, or exposure to toxic chemicals.
  • Anemia due to bone marrow disease. Some diseases such as leukemia or myelofibriosis can disrupt the production of red blood cells in the bone marrow and cause anemia. Symptoms can vary, from mild to dangerous.
  • Hemolytic anemia. Hemolytic anemia occurs when a red blood cell is destroyed by the body faster than its production time. Some diseases can interfere with the process and speed of destruction of red blood cells. Haemolytic anemia may be genetically inherited or may be acquired after birth.
  • Sickle cell anemia (sickle cell anemia). This anemia is genetic and is caused by an abnormal form of hemoglobin, causing red blood cells to be shaped like a crescent moon instead of a round bikonkaf like red blood cells. Sickle-shaped red blood cells have a shorter life span than normal red blood cells. Symptoms experienced by people with sickle cell anemia are:
    • Fatigue.
    • Easily infected.
    • Sharp pain in the joints, stomach, and limbs.
    • Delay in growth and development in children.
  • Other types of anemia, caused by thalassemia or malaria.
Are You Know?

Some risk factors that may increase the risk of anemia in a person are:
  • Lack of vitamins and iron. Getting used to eating foods that are low in vitamin B12, folic acid, and iron may increase your risk of anemia.
  • Digestive disorders of the intestine. Some diseases such as Crohn's disease and celiac disease can cause impaired absorption of nutrients in the intestine thus increasing the risk of anemia.
  • Menstruation. Generally women who still have menstruation have anemia risk is greater than menopausal women or men. It is caused by blood loss at the time of menstruation.
  • Contain. Pregnant women who do not take enough folic acid supplements have a higher risk of anemia.
  • Chronic illness. If a person has cancer, kidney failure , or other chronic diseases, then the risk of anemia will increase as a result of red blood cell deficiency. Injuries to internal organs accompanied by bleeding can also cause the body to be deficient in iron, thus increasing the risk of iron deficiency anemia.
  • Family history of anemia. A person who has a family member with a history of congenital anemia has a high risk of developing the same condition. Generally inherited anemia is sickle cell anemia ( sickle cell anemia ).
  • Age. The addition of age will increase a person's risk of anemia. Anemia due to vitamin B12 deficiency and folic acid is more common in elderly people over 75 years.
  • Other factors, such as infections, blood disorders, autoimmune diseases, alcohol addiction, exposure to toxic chemicals, and side effects from drugs can increase an anemia risk in a person.

Complications of Anemia
If left untreated, anemia is at risk of causing the following complications:
  • Heavy fatigue. Without good treatment, anemia can cause severe fatigue in the sufferer so that interfere with daily activities.
  • Susceptible to infection. Iron deficiency that causes anemia can affect the ability of the immune system in combating various pathogens, so people with anemia are more susceptible to infectious diseases.
  • Complications and disorders of pregnancy. Pregnant women with folic acid deficiency are at risk of developing pregnancy and fetal development. In addition, anemia can also cause the mother to experience postpartum depression and birth defects in infants, such as:
    • Premature birth before week 37.
    • Weight is below normal.
    • Problems with iron content in the blood.
    • Less mental ability test results
  • Heart disorders. Anemia can cause heartbeats to become irregular ( arrhythmia ) due to having to pump blood harder to compensate for the lack of oxygen in the blood. Such conditions can lead to heart enlargement or heart failure.
  • Deaths. Some congenital anemia, such as sickle cell anemia, can become serious and life-threatening to the sufferer. Blood loss with no proper treatment can cause severe anemia and death.

Diagnosis of Anemia
To find out whether a patient is anemic or not, the doctor will perform the following diagnostic steps:
  • Complete blood examination . The method of calculating blood cells is used to count the number of red blood cells present in the blood. In the diagnosis of anemia, parameters measured by the physician are hematocrit and hemogloboin in the blood. The standard number of normal hematocrit in adults varies in each laboratory, but generally ranges in 40-52% for men and 35-47% for women. Normal hemoglobin in male adults ranges in 14-18 grams / deciliters and 12-16 grams / deciliters for women. On a complete blood test, it can also be examined:
    • B shape and size of blood cells. This test aims to look at the structure of red blood cells to determine whether the structure and color of red blood cells is nomal or not, especially in sickle cell anemia patients.
    • K andungan vitamin B12 and folic acid. If doctors suspect the cause of anemia is a deficiency of vitamin B12 and folic acid, then the doctor will check the content of both substances in the patient's body to be sure.
    • The content of iron in the blood. If there is an allegation of anemia caused by iron deficiency, the doctor will perform blood protein levels in the blood called serum ferritin . Low serum ferritin levels indicate that the anemia suffered is caused by iron deficiency.
  • Other additional tests to determine the main cause of anemia. Some cases of anemia are based on certain health problems, such as injuries to an organ, so it is necessary to do a check to make sure. Bone marrow examination can be performed to assess the function of bone marrow in regenerating blood cells.
At the time of diagnosis, the doctor will also ask some things to the patient to help determine the main causes of anemia, namely:
  • Diet to determine whether the patient is eating foods with high iron , vitamin B-12, and folic acid.
  • Treatment that is being undertaken. Some types of drugs can cause bleeding in the stomach or intestines, such as aspirin or ibuprofen .
  • Menstrual cycle. Close menstrual distance, long duration and large amounts of bleeding can cause anemia.
  • Family history. To find out if any family member has anemia, gastrointestinal bleeding, or blood disorders.
  • Blood donor schedule. The doctor will ask if the patient is doing a blood donor regularly.
If the doctor does not find a definite cause after checking the medical history and symptoms of anemia in the patient, the doctor may perform a physical examination. Types of possible physical examinations are:
  • Abdominal examination to check whether there is internal bleeding in the digestive tract in the patient.
  • Check for symptoms of heart failure such as swelling of the ankle. Heart failure has symptoms that are similar to anemia
  • Rectal examination (anal plug) to check for bleeding or abnormalities in the lower bowel and anus.
  • Examination of the pelvis to check for bleeding that causes anemia during menstruation. A pelvic examination will not be performed without the patient's consent.

Treatment of Anemia
Treatment of anemia varies depending on the type of anemia suffered by the patient. The principle of treatment of anemia is to find the main cause of anemia. Treatment of anemia should not be done until the main cause is known. This is because treatment for one type of anemia can be dangerous for other types of anemia. Some examples of anemia treatment by type include:
  • Anemia due to iron deficiency. This type of anemia can be overcome by taking iron supplement supplements, and increase the consumption of foods rich in iron . In addition, patients can also be given vitamin C to increase iron absorption. It should be noted that calcium-containing supplements may inhibit iron absorption. Consult your doctor before taking iron supplements to get the right dosage. Excess iron in the body can be dangerous for the patient because it can cause fatigue, nausea, diarrhea, headache, heart disease and joint pain. To alleviate the side effects of taking iron supplements, patients can take supplements after meals. If side effects continue, see your doctor again.
  • Anemia due to vitamin deficiency. This type of anemia can be treated by eating foods rich in folic acid and vitamin B12, and taking supplements that contain both. If the patient's body has impaired absorption of folic acid and vitamin B12, treatment may involve vitamin B12 injections daily. After that the patient will be given a monthly vitamin B12 injection once that can last a lifetime or depends on the patient's condition.
  • Anemia due to chronic disease. There is no specific treatment for this type because it depends on the underlying disease of anemia. If anemia worsens, the doctor may give a blood transfusion or erythropoietin injection, a blood-boosting hormone production and fatigue-suppressing agent.
  • Anemia due to bleeding. If a person is bleeding and blood loss in large quantities, the main treatment to be done is to seek and treat the source of the bleeding. Once the source of bleeding is overcome, the patient can be given blood transfusions, oxygen, and blood-boosting supplements containing iron and vitamins.
  • Aplastic anemia. Treatment of aplastic anemia can be preceded by a blood transfusion to increase the number of red blood cells. If necessary, bone marrow transplantation may be performed if the bone marrow can no longer produce healthy red blood cells.
  • Anemia due to bone marrow disease. Treatment of this type of anemia may vary according to the patient's illness. Treatment may involve chemotherapy and bone marrow transplantation.
  • Hemolytic anemia. Handling of hemolytic anemia can be done in several ways depending on the cause. Treatment can by avoiding drugs that have side effects of hemolysis, by finding and treating infections that cause hemolytic, or with immunosuppressants to suppress the immune system that allegedly damages blood cells.
  • Sickle cell anemia (sickle cell anemia). The ultimate treatment of sickle cell anemia is by replacing damaged red blood cells through blood transfusions, folic acid supplements, and antibiotics. Another treatment is to take painkillers and add fluids through oral and intravenous to reduce pain and avoid complications. Bone marrow transplants can be used to treat sickle cell anemia under certain conditions. Medications for cancer hydroxyurea can also be used to treat sickle cell anemia.
  • Thalassemia . Thalassemia can be treated by blood transfusions, consumption of folic acid supplements, splenectomy to take the spleen, as well as transplantation of blood and bone marrow stem cells.

Prevention of Anemia
Some types of anemia can not be avoided, but anemia caused by deficiency of vitamins and iron can be prevented by adjusting the diet. Some foods that may help prevent anemia include:
  • Foods rich in iron, such as beef, nuts, iron-fortified cereals, dark green leafy vegetables, and dried fruit.
  • Foods rich in folic acid, such as fruits, dark green leafy vegetables, green beans, red beans, peanuts, wheat, cereals, pasta, and rice.
  • Foods rich in vitamin B12, such as meat, milk, cheese, cereals, and soy foods (tempeh or tofu).
  • Foods rich in vitamin C, such as oranges, peppers, broccoli, tomatoes, melons, and strawberries. These foods can help the absorption of iron.
If there is a concern that the food consumed does not contain enough vitamins, it is advisable to take a multivitamin. For vegetarians, should consult a nutritionist to manage the diet so that the body's iron needs will be met well.
If there is a family history of the emergence of anemic congenital anemia such as sickle cell anemia or thalassemia , should be consulted to the doctor. This consultation aims to estimate if there is a risk of similar anemia that can appear in children.

Anemia can also appear as a complication of malaria disease . If you will travel to a common place found malaria disease, consult a doctor related to malaria prevention drugs. Prevention can also be done by avoiding mosquito bites, such as using mosquito nets, anti-mosquito drugs, or insecticides.

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