MRCP2-2156

MRCP2-2156

A 27-year-old woman presents to the gastroenterology clinic with a flare of ulcerative colitis. She reports experiencing bloody diarrhoea for the past week, with up to 6 bowel movements per day. She denies having a fever and reports compliance with her mesalazine enemas, which have not been effective. She has no significant medical history, occasional smoking habits, and drinks alcohol once or twice a week. Her last menstrual period was 3 weeks ago.

On physical examination, she is afebrile, with normal vital signs except for mild hypotension, which is her baseline. Her abdomen is soft, with mild tenderness in the left iliac fossa.

Laboratory tests reveal a hemoglobin level of 118 g/L (normal range for females: 115-160 g/L), platelet count of 250 * 109/L (normal range: 150-400 * 109/L), white blood cell count of 11.7 * 109/L (normal range: 4.0-11.0 * 109/L), and an erythrocyte sedimentation rate of 25 mm/hr (normal range: <10mm/hr). A pregnancy test is negative. An abdominal X-ray is unremarkable. A flexible sigmoidoscopy is scheduled for the next day, which reveals mild inflammation. A previous colonoscopy showed colitis up to the ileocaecal valve. Based on the patient’s clinical history, what interventions should be considered?