MRCP2-1717

MRCP2-1717

A 28-year-old man has been experiencing persistent diarrhoea for more than 2 months. He describes passing loose, watery stool with urgency at least thrice a day. He also reports mild abdominal pain, but his primary concern is the diarrhoea. The patient has a history of Crohn’s disease and has undergone ileal resection. He is currently taking mesalazine for maintenance of his Crohn’s disease.

The following are the results of his recent tests:

– Hb 137 g/L (135-180)
– Platelets 275 * 109/L (150 – 400)
– WBC 5.2 * 109/L (4.0 – 11.0)
– Na+ 137 mmol/L (135 – 145)
– K+ 4.1 mmol/L (3.5 – 5.0)
– Urea 4.9 mmol/L (2.0 – 7.0)
– Creatinine 85 µmol/L (55 – 120)
– CRP 9 mg/L (< 5)
– Faecal culture negative
– Faecal elastase 210µg (>200)
– Faecal calprotectin 45µg (<50) What is the recommended first-line treatment for this patient, given the probable diagnosis?