To find out if a patient is anemic or not, the doctor will perform the following diagnostic steps:
- General check up. The method of calculating blood cells is used to calculate the number of red blood cells present in the blood. In the diagnosis of anemia, parameters measured by the physician are hematocrit and hemogloboin in the blood. The standard number of normal hematocrit in adults varies in each laboratory, but generally ranges in 40-52% for men and 35-47% for women. Normal hemoglobin in male adults ranges in 14-18 grams / deciliters and 12-16 grams / deciliters for women. On a complete blood test, can also be examined:
- The shape and size of blood cells. This test aims to look at the structure of red blood cells to determine whether the structure and color of red blood cells is nomal or not, especially in sickle cell anemia patients.
- The content of vitamin B12 and folic acid. If doctors suspect the cause of anemia is a deficiency of vitamin B12 and folic acid, then the doctor will check the content of both substances in the patient’s body to be sure.
- The content of iron in the blood. If there is an allegation of anemia caused by iron deficiency, the doctor will perform blood protein levels in the blood called serum ferritin. Low serum ferritin levels indicate that the anemia suffered is caused by iron deficiency.
- Other additional tests to determine the main cause of anemia. Some cases of anemia are based on certain health problems, such as injuries to an organ, so it is necessary for the examination to be confirmed. Bone marrow examination can be done to assess the function of bone marrow in regenerating blood cells.
At the time of diagnosis, the doctor will also ask a few things to the patient to help determine the main causes of anemia, namely:
- Diet to determine whether the patient is eating foods with iron content, vitamin B-12, and high folic acid.
- Treatment that is being undertaken. Some types of drugs can cause bleeding in the stomach or intestines, such as aspirin or ibuprofen.
- Menstrual cycle. Close menstrual distance, long duration and a high amount of bleeding can cause anemia.
- Family history. To find out if any family member has anemia, gastrointestinal bleeding, or blood disorders.
- Blood donor schedule. The doctor will ask if the patient is doing regular blood donation.
If the doctor does not find a definite cause after checking the medical history and symptoms of anemia in the patient, the doctor may perform a physical examination. Types of possible physical examinations are:
- Abdominal examination to check whether there is internal bleeding in the digestive tract in the patient.
- Check for symptoms of heart failure such as swelling of the ankles. Heart failure has symptoms that are similar to anemia
- Rectal examination (rectal plug) to check for bleeding or abnormalities in the lower bowel and anus.
- Examination of the pelvis to check for bleeding that causes anemia during menstruation. A pelvic examination will not be performed without the patient’s consent.