She sends a message 3 months later stating that she is 8 weeks pregnant and experiencing a flare. She never increased her mesalamine due to insurance reasons and never returned for follow up. She is having 4-6 bloody BM per day with urgency and nocturnal stooling. She is early in her pregnancy and is very concerned about another miscarriage.
What would you recommend at this point? (select all that apply)
Check stool fecal calprotectin or perform a flexible sigmoidoscopy to confirm flare
Check Stool C. Difficile
Check Quantiferon and hepatitis serologies in preparation for biologic therapy
Ensure she is seeing a maternal fetal medicine specialist (high risk OB)
Increase her mesalamine to 4.8 gm
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