26th April 2024

A 34-year-old female presents with a 4-month history of recurrent, crampy abdominal pain, frequent diarrhoea mixed with blood, and unintended weight loss.

A 34-year-old female presents with a 4-month history of recurrent, crampy abdominal pain, frequent diarrhoea mixed with blood, and unintended weight loss. She also reports experiencing fatigue and occasional low-grade fever. She denies recent travel or family history of gastrointestinal disorders. On examination, she has mild abdominal distension and tenderness, particularly in the lower left quadrant. Her temperature is 37.2°C and her pulse rate is 88 bpm.

Investigations:

Full blood count reveals mild anaemia.

Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are elevated.

Colonoscopy shows continuous mucosal inflammation and ulceration starting from the rectum and extending proximally.

Which is the most likely diagnosis?