I have ulcerative colitis. Can colitis bleeding cause anemia?

Question

Hello doctor,

I am 28 and recently diagnosed with ulcerative colitis after a colonoscopy showed inflammation in the rectum and sigmoid colon.

For the past few months, I have had loose stools with blood and mucus almost daily. The doctor started Mesacol tablets and suppositories.

Bleeding has been reduced a little, but I still have urgency and stomach cramps sometimes. So, I am looking for your opinions on:

Is it normal for medicines to take a longer time to control symptoms fully?
Also, is there any specific diet that I need to maintain, like no milk products or no spicy food during flare-ups?
The other problem is that my hemoglobin levels have come down to 10.2 lately. Is it because of bleeding from colitis or some other reason?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. According to your colonoscopy findings, you have ulcerative colitis that is confined to your rectum and sigmoid colon, or distal colitis. Your complaints of having bloody stool, mucus, urgency, and cramps are all common symptoms when experiencing an inflammatory attack. Medicines usually take several weeks to fully resolve the symptoms.

The medication Mesalamine (Mesacol tablets and suppositories) acts by decreasing the inflammation in the colon walls. The suppositories affect the rectum directly, while the tablets affect the higher part of the colon. Most patients report improvement within two to six weeks, so you might experience some urgency and cramps even in the first week of taking the medicine.

In case the symptoms do not improve after the treatment, your physician will probably alter the dosage or add some other methods of treatment.

In terms of diet, there is no one specific diet for UC; however, during flare-ups, it is useful to avoid irritating foods. Many patients temporarily limit very spicy foods, high-fat fried meals, caffeine, and alcohol. Dairy does not need to be avoided unless it worsens symptoms or you have lactose intolerance. Consuming smaller meals, along with maintaining proper hydration levels, can minimize the discomfort.

An anemia can be assumed from the fact that you have hemoglobin levels of 10.2 g/dL.Iron deficiency is one of the most common causes of anemia. In ulcerative colitis, it happens as a result of blood loss through inflamed colonic tissues.

Some important warning signs that need review include increasing bleeding, fever, severe abdominal pain, or very frequent stools. With proper medication adherence and follow-up, most patients achieve good control of inflammation and long periods of remission.

I hope this will help.

Thank you.