### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Last May I went to the Dr because I was feeling extremely weak and tired for a few weeks. Previously I had awoken one night with sweating, weakness, nausea and was very pale, I was so weak I just climbed back in bed and the next day I could not climb the stairs without resting. I wondered if I had the flu or something but the weakness persisted. When I had bloodwork done was diagnosed with severe iron deficiency (which I found unusual because I had sinus surgery in Nov and I was fine then). I am in menopause for 7 years. There was no occult blood in tests. The treatment I received was 7 iron injections. But I wanted to know the reason for the deficiency. The reason given at the time was that my pernicious anemia (PA for 15 years with monthly injections) was causing the iron to not be absorbed. However continued blood tests showed iron absorbtion from diet alone. I persevered with the Dr and he finally sent me to an internist who in turn ordered a Gastroscopy and a Colonoscopy. The results showed Negative on H. Pylori and tests for antiparietal cells postive. There are no ulcers or tumours or polyps present. Some metaplastic (sp?) cell changes probably due to a chemical bleed. (Chemical Bleed?!!) Dr said it was probably due to nsaid ingestion. I have randomly taken nsaids but never in excess or more than directed. Could a casual use of nsaid cause such a bleed and if that wasn t the cause what else could it be? Am I at risk of another bleed? Are the metaplastic cells pre-cancerous? I m confused and wanting to prevent further bleeds or catch anything possibly ominous sooner than later.

### output:

HI... sometimes NAS ID causes bleeding When its continuous use especially when taking before food ...but in gastrostomy I should find many small bleeding or not bleeding ulcers .and you should have complaints of Heartburn and Lower gastrointestinal bleeding which you do not have. H pylori has been implicated as a major cause of metaplastic (negative in your case) . Biopsy in gastrostomy should be from sites that show the typical appearance of whitish plaques, patches, or homogeneous discoloration(gastrostomy is normal in your case!!!!). There is something wrong . I advise you to do endoscopy again or take the biopsy to another lab.in the end :metaplastic in the stomach has a high cancer risk and is therefore defined as a precancerous condition. Be sure from diagnoses