Gastroenterology
Case 5: A Man with a 6‐Week History of Diarrhoea
CASE
A 24‐year‐old man presents with a 6‐week history of diarrhoea after eating out at a restaurant. He is having his bowels opened 8–10 times a day and 2–3 times at night, occasionally witnessing altered blood in his stools. He has had no abdominal pain but has had some soreness in his lower back and gritty eyes. He has lost his appetite and nearly two stone in weight. He has recently given up smoking and in passing mentioned that his cousin has Crohn's disease. He is tachycardic with a pulse of 105 beats/min and febrile with a temperature of 38.7°C. He looks dry and unwell. Abdominal examination reveals some diffuse tenderness in the left iliac fossa.
Blood tests showed:
Hb 8.9 g/dL WCC 8.6 × 109/L Platelets 658 × 109/L Plasma viscosity 2.06 cP CRP 180 mg/L Na 138 mmol/L K 3.2 mmol/L Urea 11.4 mmol/L Creatinine 140 µmol/L Albumin 27 g/L
QUESTION 1
Your score this session: 0 of 0
The best way to manage this patient would be: