<s>[INST] My nephew 40 years old has a continuing haemaglobin problem. He had a heart attack 16 months ago when his blood level was 7 and has had multiple blood transfusions since then. He also has had endoscopopys and colonoscopys plus a camera and the only results to date are that he has some damage to the lining of his stomach from medication . I feel there is an underlyng problem as his energy levels are very poor. [/INST] Hello,Damage to the lining of the GI tract is prone to bleeding.In such case he might blood constantly.This lose of blood may decrease the Hemoglobin level and cause anemia.He may need biopsy of the GI tract to find the type of lesion.Consult a Gastroenterologist. </s>