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32 yr old woman who is an editor for a publishing company comes to the physician because of intermittent diarrhea for the past 10 years, which occurs three to four times per year, lasts 2 to 4 days, and is associated with deadlines at work. During these episodes, the stool is loose and contains o melena or bright blood. Between episodes of diarrhea, she occasionally has one bowel movement every 4 to 7 days; the stool is hard and œpellet-like. She drinks one glass of wine daily. Physical examination shows no abnormalities. Laboratory studies show:

Hemoglobin 14.3 g/dL
Hematocrit 43%
Leukocyte count 8100/mm 3
Erythrocyte sedimentation rate (Westergren) 7mm/h

Which of the following is the most likely diagnosis?

a. crohn™s disease
b. colon cancer
c. diverticulitis
d. irritable bowel syndrome
e. small bowel lymphoma
f. ulcerative colitis

dddddddddddddd

F.

ahmed kk, this patient is suffering from diarrhea when she is stressed( as mentioned in the question---the diarrhea is associated with a deadline at work). and she has these symptoms for the last 10 years on and off and lasts only 2 to 4 days. otherwise the patient functions well and even if it is non specific her esr is very low.
correct me if i'm wrong.

irritable bow

fluctuate b/t diarrhea and constipation is CLASSIC

yes but its bloody

the blood confused me,we dont see blood in IBS

IRRItable can present with bloody...

bloody diarrhea does not exclude irritab

this is comon in middle age female which is in this case...

how can you dx UC ? just on bloody diarrhea alone ? by the way, i think the q said NO blood but he mispelled with O only

the q stated diarrhea and constipation in between in a middle age female

i dont remember exactly if we see blood in IBS or not ,the history is classic for IBS but without blood

CAN ANY ONE TELL CORRECT ANSWER