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Ulcerative colitis flare — GPhC CRA MCQ

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HardGI TherapeuticsUlcerative colitis flareGPhC CRA

A 72-year-old man with ulcerative colitis asks for loperamide for worsening diarrhoea. He has six bloody stools daily, pulse 104 bpm, temperature 38.1°C and abdominal tenderness. What is the most appropriate action?

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Correct answer: E — Refer urgently for suspected acute severe colitis

Bloody diarrhoea with systemic features and abdominal tenderness in ulcerative colitis suggests a potentially severe flare. Antimotility medicines may be unsafe in acute severe colitis. Urgent medical assessment is needed to evaluate dehydration, infection and need for steroids or hospital treatment. Bulk-forming or stimulant laxatives are inappropriate.

Reference: NICE CKS; BNF