Ulcerative Colitis since 15 years, He had undergone two surgeries for the same...
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This is a case of Mr. N. S (Patient Reference number: L7745), who visited our clinic with complaints of Ulcerative Colitis since 15 years. He had undergone two surgeries in the past for the same ailment. Since last one year he complained of passing loose watery stools or semi-solid stools around 8-10 times/day. He would get such episodes once a month which would last for 9-10 days. He also complained of bleeding along with the stools, continuous low grade fever, distension of the abdomen and occasional vomiting. He has been losing weight; at present weighed 49 kg (lost 3 kg in the last 2 months). The complaints would be aggravated after eating outside food. He was continuously on Wysolone, Prednisolone (oral steroids) and Mesocol for many years and has stopped it since the last 2 years. At that time he was taking Lopramide and Isabgol once per day daily. He was diagnosed as having recurrent infection of the pouch.
His appetite was average and he had a strong liking for sweet and sour food. His thirst was reduced markedly. Thermally he was chilly. His sweat was scanty and he had no urinary complaints. His sleep was sound.
He had past history of Recurrent intestinal infections, he had undergone Ileorectal anastomoses 10 years back (1994) and Ileoanal anastomosis 3 years back (2002- 03) and had undergone two surgeries in the past for the same ailment. He had history of taking Wysolone, Prednisolone (oral steroids) and Mesocol for many years and had stopped it since the last 2 years.
He did not have any other major medical illness in the past.
His colonoscopy showed Mild to moderate Pan Colitis. His blood report showed:
WBC: 16000/mm3: N 75 E2 L21M2
His family consisted of his wife, who is a housewife, no issues (H/O 2 Miscarriages), father who is retired, mother who is a housewife and a sister who is single and into medical transcription.
He was a marine engineer by profession but due to the complaints was not working for the last 6 years and had started working again since the last 6 months. He would constantly think and be troubled about small trifles and had a tendency to brood. He was very reserved by nature, couldn’t share his feelings with anyone. His main anxiety was about the finance and his health.
Based on his history, a remedy was prescribed to him, thereafter his frequency of attacks reduced to 3-4times of stool/day of normal consistency and 3 times of stools/day of watery loose stool, and the episodes reduced to once/ month lasting for 5-6 days. These episodes were not associated with any bleeding and gaseous distension and fever. He had also put on weight (Wt: 58 Kg). His treatment was continued further on similar lines since these kinds of chronic cases require long-term treatment.