A 23-year-old man presents to his primary care physician for evaluation of diarrhea for the past 6 months. The patient complains of lower abdominal pain which he describes as “crampy.” He has had several episodes of loose, watery stools. He also reports an unintentional weight loss of about 3.5 kg in the last 4 months and a subjective fever on some days over the last month. Family history is not suggestive of a similar history. He does not drink alcohol or use illicit drugs but does smoke 1 pack of cigarettes daily. He has not traveled outside of the country and is not on any medications currently. Vital signs are temperature 37.1°C (98.6°F), blood pressure 118/72 mmHg, pulse 112 beats/min, and respirations 18/min. On physical examination, the patient appears calm and malnourished. Abdominal examination reveals mild diffuse tenderness over the abdomen with no guarding or rigidity. Bowel sounds are normal. The remainder of the examination is within normal limits. Lab investigations are ordered, and the patient is referred for colonoscopy.
Which of the following is most likely to be found on the patient’s colonoscopy?
- A) Continuous involvement of the mucosa showing friability and crypt abscesses
- B) Elevated yellow-white plaques over the colonic mucosa
- C) Hundreds of polyps distributed throughout the tract
- D) No obvious pathology
- E) Segmental pattern of involvement with aphthous and serpiginous ulcers
Dr. Ted O'Connell