Chief Complaint: Crohn’s disease.
Medical History: Crohn’s disease first diagnosed twenty years previous to first visit (patient 52 years old). Soon after a right hemi-colectomy was carried out, and about 40cm of Small Intestine including appendix and ileal sphincter was removed. About 16 years of relative health followed, after which disease progressed to include ulceration in the colon. Prognosis was for a permanent stoma, and the aim of treatment was literally to see if any improvement could be gained. At time of first consultation, patient was suffering from frequent sudden senses of pain and distension, followed by immediate need to evacuate bowels. This occurred 6-7 times a day, and included bleeding
Chief Complaint: sporadic diarrhea followed by severe Rt. quadrant pain and high fever
Western Diagnosis: Crohn’s disease
Medical History: Diagnosed as Crohn’s Disease ten years ago. The frequency of the episode progressively changed to few times a year to twice a month. History of double hernia surgery 15 years ago.
Questioning exam: Malar flush, mild afternoon fever.