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What Causes Anemia And Gastric Ulcer In A 82 Year Old Man?

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Posted on Wed, 15 Jun 2016
Question: My 82 year old father is showing a hemoglobin count of 8.5 after receiving three pints of blood. His doctors include a GI who found an ulcer but there is no sign of it bleeding nor signs of blood loss anywhere. Other symptoms include cramping of the legs which we assume is from years of driving while he was employed and possible arthritis. EKG; MRI of the brain; colonoscopy and endoscopy all came back favorable. Prostate is enlarged but smooth and he is being treated for BPH with drugs such as flomax and finesteride. What else should his medical team be looking at? I'm almost thinking it's dietary but before I ask his doctors to stop testing I figure I would ask.
doctor
Answered by Dr. Ronald Schubert (25 minutes later)
Brief Answer:
Low hemoglobin

Detailed Answer:
Thank you for contacting HCM with your health care concerns

Your father was recently diagnosed with anemia and a gastric ulcer. The most likely cause of his anemia is GI blood loss either from the ulcer or from use of NSAIDs like aspirin or ibuprofen. He has had a good complete workup and my suspicion is that even though they did not see any bleeding from the ulcer that this is the root cause of his anemia.

In the next few days if his hemoglobin continues to decline then he will need further workup including a bone marrow biopsy.

Diet is sometimes a cause of anemia but not usually in otherwise healthy men. He should increase foods with iron fro the next few months which will include red meat and green leafy vegetables.

In summary
1. Anemia usual GI blood loss
2. More than likely due to Ulcer
3. Could be due to NSAID use
4. Add more red meat and green leafy vegetables which are high in iron
5. If continued anemia or lowering of hemoglobin proceed with additional testing

I hope I answered your question. Please contact us again if you have any additional questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ronald Schubert (2 hours later)
What will the bone marrow biopsy disclose? I also forgot to mention that my father has been on a vegan diet for approximately 40 years.


I also forgot to mention the GI did a biopsy of the ulcer with a histology report which also came back favorable.
doctor
Answered by Dr. Ronald Schubert (29 minutes later)
Brief Answer:
Bone marrow

Detailed Answer:
Bone marrow will be able to tell if he has enough iron stores and whether his bone marrow is compensating for the anemia by producing more blood. It will also rule out any other cause of anemia like leukemia or mulitple myeloma though those are low on the list.

Him being a vegan does put him at risk for iron deficiency since a vegan diet is low on iron containing foods. So his diet may play a part into his anemia
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ronald Schubert (9 days later)
what are your thoughts on having my father use a circulation booster device?
doctor
Answered by Dr. Ronald Schubert (1 hour later)
Brief Answer:
Circulation devices

Detailed Answer:
The circulation devices are used as last resort and can be used to bridge between medications or other treatment. I have not used them as I am a family prcitce doctor and have little experience with them I would recommend that you submit this question to a cardiologist.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ronald Schubert

General & Family Physician

Practicing since :1984

Answered : 2407 Questions

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What Causes Anemia And Gastric Ulcer In A 82 Year Old Man?

Brief Answer: Low hemoglobin Detailed Answer: Thank you for contacting HCM with your health care concerns Your father was recently diagnosed with anemia and a gastric ulcer. The most likely cause of his anemia is GI blood loss either from the ulcer or from use of NSAIDs like aspirin or ibuprofen. He has had a good complete workup and my suspicion is that even though they did not see any bleeding from the ulcer that this is the root cause of his anemia. In the next few days if his hemoglobin continues to decline then he will need further workup including a bone marrow biopsy. Diet is sometimes a cause of anemia but not usually in otherwise healthy men. He should increase foods with iron fro the next few months which will include red meat and green leafy vegetables. In summary 1. Anemia usual GI blood loss 2. More than likely due to Ulcer 3. Could be due to NSAID use 4. Add more red meat and green leafy vegetables which are high in iron 5. If continued anemia or lowering of hemoglobin proceed with additional testing I hope I answered your question. Please contact us again if you have any additional questions