Chronic Diarrhoea and Weight Loss

🗒️ Question

A 34 year old man presents with a 2 month history of diarrhoea, abdominal pain, and weight loss. He reports episodes of loose stools mixed with blood and mucus as well as occasional joint pain. He has a family history of Crohn’s disease.

On examination, he appears pale with mild tenderness in the lower abdomen. There are no palpable masses or organomegaly.

Investigations

• Haemoglobin: 11.0 g/dL (115–150)

• CRP: 35 mg/L (<5)

• Faecal calprotectin: 600 µg/g (<50)

What is the most appropriate investigation to confirm the diagnosis?

(A) Colonoscopy with biopsy

(B) Abdominal ultrasound

(C) Capsule endoscopy

(D) CT abdomen and pelvis

(E) Stool culture and microscopy