An 83-year-old man with history of left sided ulcerative colitis, recent ischemic stroke, and diabetes mellitus type 2 is admitted from the emergency department with hematochezia. The patient describes three weeks of bloody diarrhea up to 6 times daily. He has not had fevers, chills, or night sweats. He had left upper quadrant abdominal pain that was previously only intermittent with stools but is now present constantly. He has lost 10 pounds since the onset of his symptoms. He describes lightheadedness and fatigue worsening over the last several days. He was diagnosed with ulcerative colitis 15 years ago, and his symptoms have been generally well controlled on delayed release mesalamine. He has no prior history of corticosteroid use. The patient is subsequently admitted to medicine for further management.
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