BOF: 40
A thirty five year old female has had a right
hemicolectomy and resection of 30 cms of terminal ileum for ileocaecal Crohn’s
disease. She has persistent diarrhoea, which is not explosive. She does not have
abdominal pain, bloating, or loss of weight. Investigations have failed to
demonstrate evidence of recurrent Crohn’s disease.
Treatment that would relieve symptoms and give a clue to
the underlying diagnosis would be:
a)
Loperamide
b)
Steroids
c)
Cyclical antibiotics
d)
Cholestyramine
e)
Tricyclic antidepressants
Answer:
d)
The patient has had resection of the terminal ileum and
the cause of the diarrhoea is likely to be Bile Acid Malabsorption (BAM).
Treatment with a Bile Acid Sequestrants such as Cholestyramine would relieve
symptoms and point to the diagnosis.
