anemia

finusfondren7, how much testing has she had? You might want a pill camera, autoimmune testing . What is her mcv (corpuscular volume)?

What should be undertaken is to find the causes and source of the anemia. Might it be caused by bleeding somewhere, as in the GI tract, or from another source? Another cause might be insufficient production of the red blood cells, possibly due to a nutritional deficiency ( such as B12, folate) due to diet or the inability of the stomach/GI tract to absorb nutrients, or as side effects from some chemotherapy medications. As Gently mentioned, looking at the red blood cell indices ( such as size/volume, hemoglobin content that can be found in a complete blood count report can point to possible causes for the anemia, but looking at the morphology of the red blood cells on a Wright-stained blood smear can also give clues as to the nature of the anemia, and make it easier to choose the tests to pinpoint the cause of the anemia. Quite often patients with severe anemia for which the cause is still in question are referred to hematologists who have expertise in both diagnosis and treating of anemia. If your wife has recently received a couple transfusions ( most likely packed RBC units), it'd be difficult to differentiate her cells from the donor cells with either a CBC, or a RBC morphology on a stained slide- at least till some time has elapsed since those transfusions.

If it's determined that the anemia is caused by iron deficiency, for instance, the most common cause for that in post-menopausal women is bleeding, often GI bleeding. If this is suspected, occult blood testing can be performed on stool samples. If these are positive for blood, then a colonoscopy, possibly also an upper endoscopy may be performed to determine the source of the bleeding.

The anemia is generally treated with replacement of the deficient nutrients causing the anemia ( such as iron oral supplements, IV iron administration, B12 injections or oral supplements, folate supplements,) depending on what's deficient. If the anemia is severe, transfusions may be given for quick replacement of the red cells.