Discussions By Condition: I cannot get a diagnosis.

Can someone help with diagnosis

Posted In: I cannot get a diagnosis. 7 Replies
  • Posted By: t_spoon
  • April 10, 2008
  • 00:25 PM

Patient details
Male, African-American married school teacher, 37 years old, 5’10” in height
Weighs 70kg, former smoker stopped 4 years ago, blood pressure 138/80
Clinical presentation
Day 1
Loose stools and mild abdominal pain for 8 days. Cramping and fullness, feeling tired. Patient suspects food poisoning. Patient has managed symptoms by taking light meals and drinking lots of fluids. Diarrhoea has stopped.
Pronounced abdominal cramping with frequent evacuation of loose stools some of which contain blood. Feeling not related to meals. Diarrhoea comes on suddenly and impacts on his sleep and his job as a teacher.
Medical History
Past medical history unremarkable. Has never travelled outside USA. No use of antibiotics or NSAIDS
No family history of gastro-intestinal disease, cancer or autoimmune illness.
No family history of diabetes or atherosclerosis.
Medical examination
No abdominal mass or abdominal distension, but diffuse tenderness. Rectal examination shows stools containing mucuc, but no bright red blood or peri-anal disease.
Lab/clinical results
All lab results within normal ranges except presence of faecal leukocytes, decreased potassium and declining albumen.
Colonoscopy of terminal ileum has ruled out Crohn’s disease
Sigmoidoscopy shows diffuse erythema and mucopus
Endosopic biopsy histology shows inflammatory cells in lamina propria, acute cryptitis. Biopsy from normal area shows no pathology in transverse colon.

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