DEAR DR. ROACH: I'm a 73-year-old male. My recent bloodwork showed a mild anemia. My doctor ordered a second blood test and a cancer screening kit. The anemia was stable, and the screening was normal with no microscopic blood detected. He has requested that I monitor my stools for evidence of bloody or black diarrhea. I had a colonoscopy a little over three years ago that resulted in one polyp being removed, and I had mild inflammation in my colon that was attributed to the solution used to clean out the colon.
Is there any possible explanation for the mild anemia other than looking for evidence of blood in my stools? In other words, is bleeding in the intestinal tract the only explanation for my mild anemia? — C.W.
ANSWER: Anemia, Latin for "too little blood," just means the blood count is lower than normal for a person's age and condition.
If you're not making enough blood, it can be because of a lack of the nutrients needed to do so.
Losing blood is sometimes obvious, but when it isn't, the gastrointestinal tract is, by far, the leading place it is lost. Colon cancer is the first concern, but that is unlikely (but not impossible) only three years out from a normal colonoscopy.
I suspect you may be iron deficient, which is why your doctor is so concerned about loss from your gut.