From Burlington, Mass (Dr Schoetz); Burlington, Vt (Dr Hyman); Brookline, Mass (Dr Mowschenson); Hartford, Conn (Dr Cohen).
Dr Schoetz: Before we get started discussing the cases, how many people in this audience take care of patients with ulcerative colitis and Crohn's disease? It is at least half of the people that are here. I hope we can have some fun with this panel. We are basically going to talk about ulcerative colitis and Crohn's disease.
The first patient is a 32-year-old woman with a 10-year history of ulcerative colitis. She has been successfully managed as an outpatient but in the past 2 weeks has had increasing bloody bowel movements. She has been treated by her gastroenterologist with maximum doses of 5-ASA products and 60 mg of prednisone. Despite that, she is having between 12 and 20 bloody bowel movements a day, and she is admitted to the hospital for inpatient therapy.
Mowschenson PM, Cohen JL. Controversies in Inflammatory Bowel Disease. Arch Surg. 2003;138(4):440–446. doi:10.1001/archsurg.138.4.440