A 41 y old female presented to neurology with loss of consiousness (LOC) and ? seizure activity : after neuro work up including MRI brain she was found to has only Hb 4.9 with everything else normal. She did mention vomiting after she woke up from the attack of LOC associated with mild epigastric pain . That lasted for few minutes and then resolved.
She denies black tarry stool, hematochezia , hematemisis, heartburn, change in bowel habits, weight changes or any other symptoms except fatigue and dizziness.No previous medical problem , No surgeries, No smoking or alcohol . No medications either. She works as a maid
Her exam is remarkable for pallor but otherwise normal. By the time I saw her she was already transfused 2 units of blood and her Hb was up to 8. She was already tested for Iron indeces that showed significant Fe deficiency (Fe sat % was 5% - normal 20-30%)
SO what is the next step?