A 45-year-old female presents with an 8-week history
of diarrhoea with no blood or mucous, colicky abdominal pain, vomiting and
loss of weight of 10 kgs.
She has a history of appendicetomy and has
fibromyalgia for which she has been on Diclofenac SR 75 mgs b.d.
On examination she was afebrile and looked pale. The
abdomen was diffusely tender but soft. Bowel sounds were normal and rectal
examination was normal.
Hb 7.5 g/dL, MCV 70 fl CRP 235, coeliac screen
LFTs normal, urea and electrolytes normal
Colonoscopy revealed several webs with superficial
ulceration in the ascending colon. Biopsies from these areas showed
In this patient, the most important aspect of
Treat with Steroids
Treat with Mesalazine
Treat with Azathioprine
Treat with Ciprofloxacin