Case 3

A 23-year-old woman presents for evaluation of diarrhea and periumbilical abdominal pain. She describes three months of daily loose stool with intermittent traces of blood. She has 5 bowel movements a day. She often feels a sudden need to use the restroom, forcing her to rush to the toilet. She has not had incontinence but has had periods where she sits on the toilet with urgency but does not have a bowel movement. She has awakened from sleep in the middle of the night for diarrhea and has had diarrhea independent of food intake. She denies use of tobacco or illicit substances but does drink six alcoholic beverages a week. Her cardiovascular, respiratory, abdominal, neurologic, and dermatologic exams are normal.

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