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Decreased HEMOGLOBIN after ENDOSCOPIC ELECTRIC COAGULATION.

Resolved Question:

2 years old patientago it was discovered I was anemic (8,3 hemoglobin )
and that the cause was GAVE or watermelon stomach. I head about six endoscopies with electric coagulation treatments. I was feeling great once I brought up hemoglobin level with iron supplements and it seemed like the condition was resolving itself.
Here is what is really distressing and puzzling me: after my penultimate endoscopy (new doctor other retired) the doctor seemed concerned and said I would need another procedure soon. But I was feeling great!!! And the following day blood tests showed excellent hemoglobin levels!! (12.9)
A month later I had another treatment and he was pleased with progress, but a few weeks later I noticed I was out of breath etc. a lot (first time since it was first diagnosed !) and last week blood test indeed revealed my hemoglobin down (9.3).

How could this be??? My gastrointerologist said to take iron (of course) but didn't seem alarmed. Next endoscopy October 8th.

Category: Gastroenterologist, Medical

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Category: Hepatologist
 23 Doctors Online

Hello
Thanks for posting your query at DoctorSpring.com
I am Dr.R.K and I am pleased to assist you.
It is difficult to say why your hemoglobin dropped within a few weeks after the treatment. There might be an ongoing bleed from any residual lesions.
Moreover there are umpteen number of different causes for a drop in hemoglobin.
Since you have a history of GAVE, the next step is to have an upper GI endoscopy to see if GAVE is still present which might be responsible for the drop in hemoglobin.
If no lesions found, then tests for other causes should be done including a peripheral blood smear test and a stool occult blood test.
Till then you can continue taking iron supplements.
I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.


Patient replied :

Thank you so much for the thorough answer. I'm wondering if antibiotics I had to take in April and May for a urinary tract infection could have interfered with iron absorption?

thanks!


Hello.
What antibiotic did you take and for how long?
Once you answer, i will be able to help you further,
Regards.


Patient replied :

Hi, and again thanks.
The first antibiotic was nitrofuran, 5 days; then amoxicillin ten days; and finally bactrim for 7 days.
I also (after infection cleared up) was given methenamine which I take in a very small dosage: 1 GM tablet once a day.
Thanks so much!


Hello.
No, nitrofuran, amoxicillin, methanamine and bactrim do not interfere with absorption of iron in the gastrointestinal tract.
But amoxillin and bactrim can rarely cause other forms of anemia like hemolytic anemia and aplastic anemia.
But these are very rare side effects.
So the next step is to get an upper GI endoscopy done to look for GAVE lesions.
Regards.


Dr. Ratnakar Kini
Category: Hepatologist
Experience: 
Fellowship - DM - TN Dr.MGR Medical UniversityResidency - TN Dr.MGR Medical University Medical School - Stanely Medical College, TN Dr.MGR Medical University
Dr. Ratnakar Kini and 4 other Medical Specialists are ready to help you

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