Sign in to your account

Don't have an account?

Create an account
This website uses cookies to ensure you get the best experience on our website. Learn more
Black medical doctor in a white coat and red stethoscope examining a patient on a ward. Our doctors on askawayhealth have years of clinical experience to provide top notch care.

Need to check your symptoms?

Use our symptom checker to help determine what your symptoms are and to ensure you get the help you need.

Check your symptoms


Request a reset

Don't have an account?

Create an account


Reset your password

Don't have an account?

Create an account


Managing Sickle Cell Crises: Tips for Patients and Caregivers

July 10, 2021

People with Sickle Cell Disease have many health problems — some of the commonest are the ‘Sickle Cell Crises’. The first step to managing sickle cell crises is knowing what to avoid. In this article, you’ll learn about sickle cell disease, managing sickle cell crises, and what to avoid.

Sickle Cell Crises - quiet bluye skies above a group of rocks

By Dr John Afam-Osemene

What is Sickle Cell Disease?

Sickle cell disease describes different changes in the body causing serious ill health and oftentimes, hospital admissions.

The good news for individuals with Sickle Cell Disease is that they may be able to live a normal, crisis-free life. This depends on being able to successfully avoid all the triggers for a sickle cell crisis.

The difficult part is avoiding the crisis, of course, but knowing what to avoid is the first step.

The normal adult haemoglobin is HbA. (Haemoglobin is the part of the red blood cell that carries Oxygen).

Haemoglobin SS is common in Nigeria and is expressed by 1–2 persons in 100 Nigerians.

The SS genotype occurs following the inheritance of the HbS gene from both parents when both parents are AS genotypes.

Hb SS also happens when one parent has the AS genotype and the other has the SS genotype.

sickle cell crises

What are Sickle Cell Crises?

Sickle cell crises can fall into 3 groups

Vaso-Occlusive crisis

The body has an amazing capability to adjust to unfavourable conditions.

However, due to a β–globin mutation (genetic change), rather than increasing its capacity, the haemoglobin S converts to thin, long microfibres within the red blood cells (RBCs).

These change the shape of the cells from the normal sphere to a sickle; thus, the name “Sickle Cell Disease”.

These now-sickle RBCs do not flow as freely as normal cells in the blood vessels.

Eventually, they get to a point where the abnormally-shaped blood cells can no longer flow through.

Here, they accumulate and clump together and cause blockage in the blood vessel  — leading to a vaso-occlusive crisis.

How the vaso-occlusive crises progress

When vaso-occlusion happens, it cuts off the blood supply to the surrounding tissue.

Since these tissues need blood and oxygen to survive, they die as a result of a lack of blood supply.

First, small blood vessels and small areas of tissue are affected.

These tissue deaths (infarction) could worsen to involve large portions of organs, causing severe pain in the organs where these tissues are located.

Haemolytic crises

Secondly, sickle cells are fragile and easily broken down within the vessels.

The spleen is the major organ responsible for the destruction of old or abnormal RBCs.

In an attempt to restore things to normal, the spleen works double-time to destroy the sickle cells.

The bone marrow also works at a rapid pace to replace the destroyed cells.

This is how the Haemolytic crisis happens.

The term haemolysis refers to the destruction of blood cells.

Loss of the blood cells reduces the haemoglobin available for carrying oxygen and causes the anaemia common in people with Sickle Cell disease.

This is how haemolytic anaemia  happens — making the individual easily tired with reduced stamina.

Haemolytic anaemia is a blood disorder resulting from the excessive destruction of red blood cells (RBCs), leading to the reduced oxygen-carrying ability of the blood.

Sickle Cell Anaemia is a type of haemolytic anaemia commonly referred to as “SS”.

Aplastic crises

Finally, the Aplastic crisis happens specifically because of an infection with a virus called  —  Parvovirus B19.

Usually, in children without Sickle Cell Disease, the Parvovirus causes an infection that is harmless in nature.

It settles itself — usually by the fifth day – this is why it is also known as ‘the 5th disease’.

The symptoms include mild fever, a rash and appearing a little ‘unwell’.

In kids with Sickle Cell Disease, the virus kills red blood cell producers in the bone marrow.

This effect leads to a massive drop in haemoglobin available well before the viral infection ends by itself, and new cells start to form again.

Sickle cell crises

How do the Sickle Cell Crises Begin?

Certain triggers lead to sickle cell crises.

When exposed to these triggers that ultimately increase the body’s need for oxygen, the HbS gene is not as efficient as HbA.

The triggers for these crises include:

  • Infections
    •  Malaria infections, Typhoid infections, Parvovirus B19 infection (as in Aplastic crisis).
  • Dehydration
    • This happens when the body has insufficient fluid to meet its needs.
    • It can be caused by: drinking insufficient water, excessive sweating in very hot weather, or losing fluids from an illness like diarrhoea and vomiting.
  • ​Deoxygenation
    • This occurs when the body finds itself in conditions with low oxygen levels, high altitudes, violent cold, extreme heat, excessive exercise, smoking, and blockage to blood flow (from tight clothing, prolonged posture etc).
  • Acidosis
    • This happens when the body’s fluids contain too much acid and is a sign that the Kidneys or lungs, which control the body’s acidity, are not working properly.
  • Stress.
    • This could be stress from different causes – emotional, physical etc.
sickle cell

Some Features of Sickle Cell Crises

  • Bone pains
    • Painful swollen fingers and toes in children;
    • Leg ulcers due to obstructed blood flow and tissue death.
  • Breathing problems
    • Chest pain due to lung involvement.
  • Enlarged liver and spleen, especially in children
    • Jaundice (yellowing of the mucous tissues);
    • Gallstones due to hemolysis.
sickle cell crises

Successfully Managing Sickle Cell Anaemia

1. Know your genotype to inform important decisions about your family life, social life and work life.

2. Avoid triggers of sickle cell crises.

3. Good nutrition and hygiene.

4. Vaccinations.

5. Stay warm, well-rested and hydrated.

6. In cases of crisis, see a doctor as soon as possible.

More Reading

Editing by AskAwayHealth Team


All AskAwayHealth articles are written by practising  Medical Practitioners to help promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
Please get in touch with a health practitioner
 to discuss your condition, or reach us directly here. 

Our post contains affiliate links at no cost to you. You are in no way obligated to use these links. Thank you for being so supportive!

Image Credits: Canva

Share this blog article

On this page

Let us know what you think

Want to know how your comment data is processed? Learn more

Access over 600 resources & our monthly newsletter.

Askawayhealth 2023 grant recipient from European Union Development Fund

Askawayhealth, 2023 Award Recipient

Our educational content meets the standards set by the NHS in their Standard for Creating Health Content guidance.

Askawayhealth aims to deliver reliable and evidence based women's health, family health and sexual health information in a way that is easily relatable and easy for everyone to access.

Askawayhealth symptom Checker tool image

Utilize our complimentary symptom checker tool to gain more information about any uncertain symptoms you might have.