A GI cancer would be unlikely following a normal upper and lower endoscopy, although cancers do rarely occur in the small intestine (less than 2% of all GI tract cancers occur in the small intestine).
I think that the capsule endoscopy is a logical next step.
Hopefully, nothing serious will be identified. Unfortunately, it is not possible to render specific diagnoses over the Internet. Bloating and constipation are, however, very common symptoms, especially among women, and can be caused by a variety of factors. Anemia is also very common in young women, and can be caused by heavy menstrual periods (especially if the patient does not have adequate iron in her diet), as well as by other health issues. Anemia and blood in the stool is most commonly caused by non-cancer diseases, including hemorrhoids, although cancer must always be ruled-out. Unfortunatley, your sister will have to complete her work-up in order to determine the cause(s) for her symptoms.
Sincerely/ Robert A. Wascher, MD, FACS
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