Inflammatory Bowel DiseaseCase StudyThe patient is an 11-year-old girl who has been complaining of intermittent right lowerquadrant pain and diarrhea for the past year. She is small for her age. Her physicalexamination indicates some mild right lower quadrant tenderness and fullness.Studies ResultsHemoglobin (Hgb), 8.6 g/dL (normal: >12 g/dL)Hematocrit (Hct), 28% (normal: 31%-43%)Vitamin B12 level, 68 pg/mL (normal: 100-700 pg/mL)Meckel scan, No evidence of Meckel diverticulumD-Xylose absorption, 60 min: 8 mg/dL (normal: >15-20 mg/dL)120 min: 6 mg/dL (normal: >20 mg/dL)Lactose tolerance, No change in glucose level (normal: >20 mg/dL rise inglucose)Small bowel series, Constriction of multiple segments of the small intestineDiagnostic AnalysisThe child’s small bowel series is compatible with Crohn disease of the small intestine.Intestinal absorption is diminished, as indicated by the abnormal D-xylose and lactosetolerance tests. Absorption is so bad that she cannot absorb vitamin B12. As a result, she hasvitamin B12 deficiency anemia. She was placed on an aggressive immunosuppressiveregimen, and her condition improved significantly. Unfortunately, 2 years later sheexperienced unremitting obstructive symptoms and required surgery. One year after surgery,her gastrointestinal function was normal, and her anemia had resolved. Her growth statusmatched her age group. Her absorption tests were normal, as were her B12 levels. Herimmunosuppressive drugs were discontinued, and she is doing well.Critical Thinking Questions1. Why was this patient placed on immunosuppressive therapy?2. Why was the Meckel scan ordered for this patient?3. What are the clinical differences and treatment options for Ulcerative Colitis and Crohn’sDisease? (always on boards)4. What is prognosis for patients with IBD and what are the follow up recommendations formanaging disease?note:reference at least two updated, and APA format, with plagiarism rate 0%, if possible attach%
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