A Case of Persistent Anemia and Alcohol Abuse

Gemma Lewis; Matthew P Wise; Christopher Poynton; Andrew Godkin


Nat Clin Pract Gastroenterol Hepatol. 2007;4(9):521-526. 

In This Article

Treatment and Management

Abstention from alcohol is key to halting the progression of alcohol-related anemia. Acute withdrawal symptoms can be managed by a short course (e.g. 3–7 days) of gradually reduced doses of benzodiazepines, such as chlordiazepoxide. Abstention is easily maintained in some patients, especially when physical illness emerges, whereas other individuals might require more-specific psychological counseling to help manage their addiction. Medication to reduce the urge to drink has been shown to be superior to placebo for the maintenance of abstinence. For example, acamprosate and/or coadministered naltrexone for 3 months reduced relapse rates from 75% (placebo) to 50–60% (either drug alone) and 25% (combination treatment).[8] Disulfiram, which causes extremely unpleasant adverse effects if alcohol is ingested, is occasionally still used to encourage abstinence in selected patients. Anemia is corrected in alcoholics not only by stopping alcohol intake, but also by treating other underlying conditions (e.g. nutritional deficits). Blood transfusion is reserved for patients with symptomatic anemia, or for patients with severe hemorrhage with cardiovascular compromise. If the anemia results from a true iron deficiency and blood loss from the gastrointestinal tract, this needs to be investigated appropriately. In the present case, the patient managed to stop drinking with close monitoring and counseling on an outpatient basis and without the need for pharmacological adjuncts.


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