Seeking Guidance on My Mother’s Persistent Severe Anemia
Hello everyone,
I am quite concerned about my mother, who is 42 years old and 5'2" tall, weighing approximately 55 kilograms. She has been battling severe anemia for more than a year now, and her condition seems to be deteriorating despite ongoing treatments. Here's an overview of her situation:
**Medical History:**
- **Age:** 42, Female
- **Height:** 5'2"
- **Weight:** Approximately 55 kg (her weight decreases significantly when hemoglobin levels drop, and while she regains some weight after transfusions, she remains thinner than she used to be).
- **Gastrointestinal History:** No previous stomach issues, such as pain or bloating, until March 2024 when she first experienced anemia. Stomach pain surfaced by April 2024.
**Hospital Visits and Evaluations:**
- **March 2024:** Admitted with a hemoglobin level around 4.0; received blood transfusions and iron supplements.
- **Endoscopy Findings:** Diagnosed with pan-erosive gastritis.
- **4–6 Months Later:** Hemoglobin decreased again, necessitating further transfusions and iron treatments.
- Both stool occult blood tests returned negative on two occasions. A colonoscopy and bone marrow biopsy were recommended but postponed due to financial issues.
**Gastrointestinal Assessments (Later 2024):**
- **Repeat Endoscopy and Colonoscopy:**
- **Endoscopy Results:** Confirmed pan-erosive gastritis and detected H. pylori, which was treated with antibiotics. Notably, she experienced bright red stools during the treatment.
- **Colonoscopy Findings:** Discovered caecal aphthoid ulcers with active bleeding.
- **CT Enterography Report:** Showed asymmetrical bowel wall thickening with mural edema.
- **Biopsy Result:** Negative for tuberculosis, yet the report indicated that inflammatory bowel disease (IBD) or Crohn’s disease could not be excluded.
**Treatment Regimen:**
- She was prescribed mesalamine, budesonide, and esomeprazole.
- Approximately ten days later, her dark stools improved. However, 1.5 months later, hemoglobin dropped back down to 4.3.
- Four blood transfusions elevated her hemoglobin to 9.8, but shockingly, within 25 days, it plummeted to 5.9 again.
**Other Symptoms:**
- Ongoing stomach pain every day, mainly at night (beginning in April 2025).
- Noteworthy swelling on the right side of her abdomen resembling a small ball, which resolves without intervention after a few hours.
- Occasional pain in the lower abdomen.
- Stool color has been dark green to black for over a year, occasionally lighter but never fully returning to normal.
- Liver and kidney function tests have shown minor changes only, remaining within normal limits.
- Hematology results indicate microcytic hypochromic anemia, with stable white blood cell and platelet counts.
- Tests returned negative for hepatitis and HIV.
**Current Situation:**
Her anemia continues to recur, with no improvement from iron supplements or transfusions.
- Hemoglobin now declines at an alarming rate — previously every 3–4 months, now within just 20 to 25 days.
👉 Has anyone experienced similar anemia associated with Crohn's disease or IBD?
👉 Should we advocate for a bone marrow biopsy, capsule endoscopy, or other diagnostic procedures?
👉 Might there be underlying non-GI tract issues, despite normal white blood cell and platelet counts?
We feel increasingly overwhelmed and anxious since her anemia does not stabilize. Any insights, experiences, or recommendations on questions we should pose to our doctors would be immensely appreciated.
Thank you all in advance!
RheumatologyNeck PainAbdominal Pain