Inflammatory Bowel Disease — Clinical

A 32-year-old man from Mumbai with a 3-year history of Crohn disease (ileocolic involvement) on azathioprine and mesalamine presents with a 2-week history of fever (38.5°C), right lower abdominal pain with a palpable mass, and mild diarrhea. Abdominal ultrasound shows a 4 cm × 3 cm hypoechoic mass in the right iliac fossa with surrounding bowel wall thickening. Laboratory findings: Hb 9.2 g/dL, WBC 12,500/μL, CRP 8.5 mg/dL. What is the most likely diagnosis?

A 32-year-old woman with a 6-year history of inflammatory bowel disease presents with chronic diarrhea and abdominal pain. Colonoscopy reveals continuous inflammation from the rectum extending to the splenic flexure, with loss of haustra and a lead-pipe appearance on imaging. Which single feature most reliably distinguishes her condition from Crohn disease?

A 32-year-old man with newly diagnosed moderate ulcerative colitis (UC) presents with bloody diarrhea (6–8 stools/day), abdominal cramping, and mild systemic symptoms. Colonoscopy confirms continuous mucosal inflammation limited to the colon. Which is the drug of choice for induction of remission in this patient?

A 32-year-old woman with a 6-year history of ulcerative colitis (UC) presents with a 3-week history of bloody diarrhea (8–10 stools/day), abdominal pain, and fever (38.2°C). Laboratory investigations show Hb 9.2 g/dL, WBC 14,500/μL, CRP 8.5 mg/dL, and albumin 2.8 g/dL. Sigmoidoscopy reveals continuous mucosal ulceration with loss of haustra. She is currently on mesalamine monotherapy. What is the most appropriate next step in management?

A 32-year-old man from Delhi presents with a 6-month history of bloody diarrhoea, abdominal pain, and weight loss. Clinical examination reveals pallor and mild abdominal tenderness. Laboratory investigations show haemoglobin 9.2 g/dL, albumin 2.8 g/dL, and elevated inflammatory markers (CRP 8.5 mg/dL, ESR 52 mm/h). Which investigation is most appropriate to confirm the diagnosis of inflammatory bowel disease and determine disease extent?