What causes pain during dehydration in a sickle cell anemia patient?

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Yes, sickle cell anemia is a disease where RBC shape changes while dehydration and oxygen level goes down in body. Usually red blood cell will be round and plate shape. During dehydration and less oxygen time the shape of the red blood cell becomes sickle shape. Now RBC will stick together and block the blood vessels and produce ischemia.

So to reduce the obstruction, you need fluids more. If obstruction is in lung, spleen, kidney or any organ, it is dangerous and severe painful. So avoid dehydration conditions, do not do severe exercise, avoid going to hill stations where oxygen is less. Drink adequate water.