Another battery of tests has shown nothing. The patient declined a third endoscopy - the last two showed nothing.
The response from "unregsitered" 0n 5/30 was helpful - and after the new set of tests I have the following response & questions:
'Unregisterd' suggests looking at clotting or bleeding disorders - both checked and cleared. No booze involved, no anti-inflammatory drugs, no ulcers, etc.
I would like to test the possiblily of
a -Celiac disease: by taking the patient off gluten. (Wheat is a staple here (India) - patient's diet includes whole wheat, as 'chappatis' and occasionally white bread.) Other than wheat and its dervatives is there anything else I should be omitting from her diet? (The patient is not indigent, but certainly of a low-income family. Hence - no processed foods, sauces, little if any meat/fish/poultry, no canned food etc.)
b-Exotic parasite: ameba & giardia are rampant in the area. Its possible the patient has had one or both all her life. Could either of these cause the bleeding symptom? (stool has been tested, but sometimes the ameba is hard to detect?) Are there any other parasites that are hard to detect?