Husband with cirrhosis has low haemoglobin

[Spooks58]

My husband is 63 and was diagnosed with cirrhosis, ascites, jaundice and HE two years ago when he spent a week in hospital. Since then he hasn't touched alcohol and looks much better but the consultant said today that he's a bit concerned about his low haemoglobin levels. Is this likely to be just anaemia or something more sinister? Thanks.

[AyrshireK]

It could be anaemia or potentially sign he has a bleed somewhere.

My hubby had iron deficient anaemia and had a course of (prescribed) iron tablets. He also had further endoscopies (as obviously he'd had one bleed already). PLUS, had a colonoscopy to check for any issues in the bowel etc.

Hopefully doctor is going to do more follow up.

Katie

[Cat-B]

It’s anaemia. It’s the cause that needs to be investigated. Please don’t try to overthink, just wait for the investigations and results. Good luck

[Aotea2012]

I had anaemia I also have cirrhosis. I had blood tests which showed low haemoglobin and iron levels. At the time I was getting terrible nosebleeds although my platelets and clotting time were normal. My nose was cauterised and it sorted out the nose bleeds. They didn’t think the anaemia was down to the nosebleeds so had a lot of tests. Endoscopy, colonography, lots of blood tests. Everything came back ok. The endoscopy showed two small grade 1 varices, already known about, but showed no sign of bleeding or red flags for bleeding. They talked about capsule endoscopy, but wanted to wait to see what happened first. I had two lots of iron infusion which got my bloods back to normal and then waited. I felt fine and had another set of bloods which came back normal. Then a few more done a bit later, again all normal. So they put the anaemia down to the nosebleeds. My bloods are now all normal, I take no medication and the anaemia has gone. My consultant did say that anaemia and cirrhosis often go together and that they want to make sure that there’s no bleeding anywhere before they put it down to the cirrhosis alone. He may need to go onto iron tablets or have an infusion. I was fine after both. So expect some tests and some treatment. If they can pin point the cause and eliminate then obviously that’s best.

[GG100]

My husband was diagnosed with decompensated cirrhosis Jan 2021, but in fact a few months before he had an emergency visit to A&E for a transfusion as his Heamoglobin was down to 48. Endoscopy showed something they call 'watermelon stomach' or officially G.A.V.E. although at that point they didn't follow up and discover cirrhosis (until he was jaundiced in January). He has a more or less continual small bleed into his stomach and often has top up transfusions and occasional iron infusions in outpatients, we get his blood tested every 2 weeks to monitor the situation. He does not have oesophageal varices which are more dangerous and can give large life threatening bleeds. He has low platelets, red blood cells and white blood cells and low clotting time. It all just needs monitoring to keep it under control.There is not really a 'just' anaemia, it is probably down to his cirrhosis, your doctor should start with an endoscopy, but if it is similar to my husband it is reasonably simple to keep it under control. I can usually tell when a bleed kicks in, he gets black stools and more sleepy and often becomes constipated. The regular blood tests are to get a transfusion before side effects start.