Ulcerative Colitis case study
Patient Name: Mr. Jeremy Martins
Age: 64 Year
Sex: Male
Marital Status: Married
Residence: New York, Down
The patient presented with complains of diarrhea for a week. The diarrhea is watery and characterized with the presence of blood in the stool. Diarrhea requires frequent visits to the washroom when severe. The diarrhea is also accompanied with abdominal pains. The blood in the stool is also fresh, and no clots are formed. Over the last two days, the patient noted mucus and pus in the stool. In some instances, the patient reports feeling the urge to go the washroom, but on going to the washroom, nothing comes out. The symptoms are accompanied by fatigue and loss of appetite and fevers. The blood pressure was 120/80 mmHg, Temperature 38 degrees Centigrade, Pulse 72 beats/ minute and the respiratory rate of 21 breaths per minute. On physical exam, the patient was in fair general condition, no pallor, no jaundice, no cyanosis or dehydration was noted. The patient also guarded against pain on the left pelvic region. The laboratory investigation showered increased c- reactive proteins, mild anemia and increased levels of White Blood Cells. Stool test was done showed the presence of blood and pus. Colonoscopy was done, and a diagnosis of Ulcerative Colitis was made. Colonoscopy was an indicated diagnostic tool for ulcerative colitis (Grossman, & Morton, 2014). The patient was hospitalized. The treatment provided was Anti-inflammatory prednisolone and 5- amino salicylic acid based medications. Additionally, the patient was provided with one pint of whole blood and hematinics. Normal saline 1liter in 24 hours and Iron Sucrose were also administered intravenously. The patient was discharged after five days of hospital stay and book for further management at the hospital’s outpatient set up.
References
Grossman, & Morton. (2014). Gastrointestinal Hormones and Pathology of the Digestive System. Springer Verlag.
