ABSTRACT
Bloody diarrhoea and weight loss are two symptoms that indicate significant intestinal pathology. Diarrhoea, abdominal pain and weight loss, with or without rectal bleeding, are typical features of Crohn’s disease. A patient may present with a fistula or an abscess; the clinical features will depend on the location, extent and severity. Electrolytes should be checked, as profuse diarrhoea can lead to both dehydration and potassium loss. Albumin can be low, as proteins are often lost in diarrhoea. Inflammatory markers (CRP/ESR) are useful in determining if the disease is responding to treatment. Endoscopy is important to assess the appearance of bowel mucosa and also allows biopsies to be taken for histology. In the patient with acute colitis there is an increased risk of perforation. Acute colitis is a life-threatening condition and the patient may need an urgent colectomy.
