Low hemoglobin/blood transfusion/Entyvio

I have had what I thought was minor bleeding for 10 months (though the last couple weeks I didn't see any blood) and was admitted to the hospital on Friday after nearly passing out during an echo cardiogram and they discovered that my hemoglobin was extremely low and I needed a blood transfusion.

I was at the hospital getting tests to try to figure out what has been causing the intermittent fevers and shortness of breath I have been dealing with for about the last month. I had a couple CT scans prior to the echo but at the end of the echo is when I got extremely light headed, my blood pressure dropped and I couldn't sit up for quite a while. The techs called my doc who said I should go the the ER to get evaluated and while there they discovered the low hemoglobin

The hospital doc didn't say much about the results of the echo or the scans -- will have to get with my pcp this week.

I had thought that maybe the 4 week dosing of Entyvio was starting to work since I I wasn't seeing blood anymore, though stool consistency was worse -- it had been fairly well formed, but now it's just small pieces ...still not diarrhea but no where near as formed as it was a couple months ago. The low hemoglobin and getting the blood transfusions has really scared me and I think I need to give up on Entyvio. Entyvio is the only biologic I ever used so I know I have lots of other options.

I had blood tests a couple weeks ago and it showed that I was slightly anemic, but since I hadn't seen any blood since then I thought things were getting better with my colon. I guess I was still losing blood even though I wasn't seeing it anymore. (Yesterday AM I did have an episode of bloody diarrhea in the hospital after they had given me a Lovenox shot when I was admitted on Friday. No blood today and stool is more formed than it has been.)

Has anyone had anything like this ... needing a blood transfusion without seeing blood in abnormally formed stool? I hate giving up on Entyvio because it worked so well for me (until the bleeding started in Jan), but I know I can't go on like this.

Last scope was in June and showed mild inflammation in the rectum, more severe inflammation in the sigmoid, clear the rest of the way. BMS are 3-4 times a day, no urgency.

I wonder if you have inflammation within the small intestine, that's limiting your iron absorption. Consider a MRI with contrasting dye to see how the small intestine looks? You mention Crohn's-colitis, so it's not impossible to have higher-up inflammation in your case. Inflammation in the terminal ileum impacts iron absorption.

Please let us know what you hear. I am so sorry you ended up in the hospital. What a crazy whirlwind this UC is. I am happy you're on the way to making new plans. I'd probably go to remicade before Humira, simply because the response rate there is the highest and there is not most room for flexible dosing. Humira is the same dose for everyone of all sizes. You can double up but it's not as flexible. I get the appeal of humira though, the quick shot at home is so much more convenient.