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Functional Dyspepsia/GERD approach — ESEGH MCQ

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HardGastroenterologyFunctional Dyspepsia/GERD approachESEGH

A 64-year-old woman has six months of nocturnal, non-bloody watery diarrhoea. Faecal calprotectin is 76 micrograms/g and colonoscopy is macroscopically normal. What should the endoscopist do to evaluate the leading organic diagnosis?

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Correct answer: A — Obtain right- and left-sided colonic biopsies

Option A is correct because microscopic colitis may have a normal endoscopic appearance and patchy histology, so right- and left-sided biopsies improve detection. Option B under-samples and relies on a lower-yield site. Option C is not the diagnostic method for microscopic colitis. Option D bypasses the affected organ, and option E mistakes normal macroscopic appearances for normal histology.

Reference: BSG guideline: investigation of chronic diarrhoea in adults. https://gut.bmj.com/content/67/8/1380