Urgent: Is My Mum's Acute Anemia Due to Internal Bleeding ?

Hi, I know it's a long shot but I'm posting with the hope that someone who has experienced this before or has seen a similar case before as a doctor will be able to help.

My mother, whose health condition I'm asking about, is 71 years old. She has been in hospital for 4 weeks. She was warded under gastroenterology for acute anemia with a low hb level of 6 (normal: 12). Her Hb was 13.9 in the year 2005 and 12.4 in late 2006. Her doctors suspected gastrointestinal bleeding as she had been taking aspirin and painkillers for osteoarthritis. She also had very bad constipation and had to rely on lactulose daily until this week.

The doctors did an OGD, after which they did a colonoscopy. This was in Week 1. The OGD findings were that she had some gastritis and a fair bit of erosions. The colonoscopy found that she had divetricular (spelling?) disease. However, her doctors concluded that these probs could not have caused a 50% drop in her blood over 8 months. They also noted that her ioleal had a bulky view.

In Week 2, she did a CT scan, which found a mass abt the size of a chicken egg near her uterus. An ultrasound scan showed that it was prob a fibroid. The gynae said there was fluid in it, suggesting that it could be an old fibroid and that it was degenerating, not likely to have caused her blood loss.

In Week 3, my mum did a capsule endoscopy to check her small bowel. The doctors found some 'red spots' in her small intestine. However, the 'red spots' did not appear to have been bleeding actively during the 8 hours that the pill camera was inside her body. Again, the doctors concluded that they could not have been the cause of her bleeding.

At the end of Week 3, the doctors told me that they suspected either TB of the gut or a bone marrow prob. They thought her anemia might be caused by a form of blood cancer called myeloma, as my mum also had hypercalcemia of 2.79, which may suggest bone loss.

My mum did both the TB and myeloma tests, which all came back negative. The haematogist, however, hasn't completely ruled out a bone marrow prob. She will be doing a bone scan tomorrow and may suggest a bone marrow aspiration.

Her doctors from gastroenterology would like to check the fibroid in the uterus again, but the gynae dept seems quite sure that it is not the cause of her prob. My mum does not remember having any vaginal bleeding after menopause.

My mum has done thru 3 blood transfusions in all. Her blood count rose from 6 to 8, then to 10, then dropped to 7.7 over the third week (possibly because of too much blood drawing). She was transfused again and her blood count is now 10.

My questions are:

Is there anything else left unexplored in the gastro area? Is it likely that her doctors could have missed something? I read abt angiography. Is this another step they can take to further explore her gastro problem?

My mum has been diagnosed as having iron-deficiency anemia. However, she is also noted to have a high ferritin level. Does it mean that hers is not a 'true' iron defiency, in that the iron has been deposited somewhere else in her body?

My mum's family, as far as I know, does not have any history of leukemia or other blood-related cancers. My maternal grandmother died of acute appendicitis. My maternal grandfather died of pneumonia. My mum has hypertension, high cholestrol, angina but with no blockage in her coronary arteries from a test done last yr. She also has mild diabetes and is on diet control with no medication.

As my mum has a habit of not cooking and eating bread for lunch, could her acute anemia have been triggered by a long period of poor nutrition?

Other details abt my mum's condition: Her iron level is very low at 2. Her albumin level is low at 17. Her MCV and MCHC levels are slightly low, suggesting perhaps smaller red blood cells? Her ALP, Gamma GT, CRP and ESR are also high. Her CRP level was reduced after she was given antibiotics for presumed sepsis.

My mum is feeling very down because of her long stay in hospital and the numerous blood tests and scans she has to do. The long hospital stay is also taking its toll on our finances. With her current condition, is it advisable for us to request for her to be discharged with outpatient follow up?

Pls do post a reply if you have ever come across such cases. I'm really at my wits' end.