Abstract
Objective:Malabsorption is one of the causes of iron deficiency anemia in postmenopausal women. The main objective of this study was to access the frequency of malabsorption in iron deficient anemic postmenopausal women.Methods:A total of 123 postmenopausal women were enrolled in the study. Of these 123 women, 50 were included as ‘control group’ and 73 patients with comparable severity of anemia were the ‘patient group’. Two tablets of ferrous sulfate (200 mg/tablet) along with one tablet of vitamin C (500 mg) were given to all participants. Serum iron levels were determined on samples collected from all participants before and after the administration of ferrous sulfate. Difference between before and after serum iron levels of normal and patients were compared.Results:No change in serum iron between sample one and sample two represented malabsorption. Out of 73, 5 postmenopausal anemic patients showed no change in their serum iron level after the administration of ferrous sulfate. This study shows that frequency of malabsorption of iron in postmenopausal women is 6.8%.Conclusion:Malabsorption should be considered as a prevalent cause of iron deficiency anemia in postmenopausal women. It should be properly diagnosed and iron response should be monitored properly in postmenopausal women with IDA after oral iron therapy. If a postmenopausal woman does not show any response to oral iron therapy, she should be evaluated for iron loss (blood loss and/or malabsorption). Intravenous route should be used for the administration of iron in these patients.
Highlights
Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in developing as well as developed countries.[1,2,3] It results from decreased iron stores due to inadequate iron intake, poor absorption and increased iron demand and/or blood loss.[4,5,6] Iron is essential for the production of erythrocytes; if its supply is inadequate, red cell production declines
Malabsorption is the inability of gastrointestinal tract to absorb ingested nutrients and micronutrients
Various diseases such as celiac disease, inflamatory bowel disease (IBD), whipple’s disease, tropical sprue etc. may lead to malabsorption of essential nutrients i.e. iron, vitamin B12, folate and vitamin A.19,20. Malabsorption diseases such as celiac disease, inflammatory bowel disease (IBD) and H.pylori gastritis are frequently associated with iron deficiency anemia.[7,21,22]
Summary
Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in developing as well as developed countries.[1,2,3] It results from decreased iron stores due to inadequate iron intake, poor absorption and increased iron demand and/or blood loss.[4,5,6] Iron is essential for the production of erythrocytes; if its supply is inadequate, red cell production declines. This leads to the development of microcytic and hypochromic anemia.[3,7] IDA rarely occurs in isolation. It usually associated with other conditions such as hookworm infestation, nutritional deficiency, malabsorption, hemoglobinopathies etc.[8,9]
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