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Case 36 

Case 36
Chapter:
Case 36
Author(s):

Alissa J. Walsh

, Otto C. Buchel

, Jane Collier

, and Simon P.L. Travis

DOI:
10.1093/med/9780199557899.003.36
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date: 21 August 2019

A 55-year-old woman who worked as a publisher presented with an 8-week history of diarrhoea. She reported up to 12 bowel movements in 24 hours with nocturnal waking to open her bowels. Stools were loose, but contained no macroscopic blood. She experienced lower abdominal cramps and urgency before having to pass stool, and this was especially prominent after a meal. She had no fever or chills but had lost weight. Symptoms started after a course of Co-amoxiclav, which was prescribed for a chest infection. The diarrhoea was having an appreciable impact on her quality of life, interfering with normal daily excursions for fear of not being near a toilet. She had chronic backache, suffered from depression, and was hypothyroid. She was receiving fluoxetine, thyroxine, and had been taking diclofenac for years.

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