A 27 year old female who is
known to have Crohn’s disease and who has had a right hemicolectomy presents
She has not been on drugs to
maintain remission of Crohn’s disease.
On examination apart from
scars of previous surgery, there are no physical signs detected.
unremarkable apart from a Hb level of 9.6 g /dL.
As part of her evaluation
she undergoes colonoscopy which is reported as showing normal mucosa.
Biopsies of the colon show
infiltration of lymphocytes in the lamina propria.
In this patient which one of
the following would be the likely underlying diagnosis?
Small bowel bacterial overgrowth
Recurrent Crohn’s disease
Bile acid malabsorption