Yes that all makes sense, the last time i had a conversation with my Haemotologist a few years back about this, he suggested an endoscopy, then my surgeon disagreed with him and they had a bit if back and forth, then i just decided to accept it is J Pouch related and common etc.
So should i be requesting blood tests for the red cell destruction and age etc that you mentioned? Apologies as this kind of stuff is way over my head, and sometimes with doctors in the UK you have to take the lead and initiative.
It’s just so i know what to ask him.
With regards to possible chronic disease, i don’t know where i would start, or what doctor to see, my surgeon is probably my best bet in that respect as GP’s over here have no idea what a J Pouch is.
The testing for hemolysis (haptoglobin, retic count, LDH) should be part of any hematologist’s arsenal. There are both mechanical and autoimmune causes. Perhaps the hematologist saw clear evidence of iron deficiency anemia in which case there must be bleeding from somewhere if your irons stores are depleted 5 weeks after infusions. Anemia of chronic disease is diagnosed when a pt has normal to high ferritin (marker of inflammation) and low to normal iron binding capacity along with a chronic inflammatory disease. Essentially you have enough iron but the chronic inflammatory state is effecting production. Giving iron is not going to help in that case. I read your above post and yes, steroids can definitely cause gastritis and upper GI bleeding. I guess another issue could be chronic kidney disease but you haven’t mentioned that. Good luck! I hope you find some answers.