Physician's Assistant

Patient Details

Refined clinic letter (290 days ago 08:56)

Refined clinic letter Fri 20 June 2025 08:56

Last Modified: 290 days ago

MRN:

Content:

Diagnosis:
Extensive Colitis (IBD-U) - diagnosed February 2005
- Last flare: 2017

Other Medical Diagnoses:
• Appendicectomy - June 2020
• Family history of bowel cancer (father)

Current Medications:
• Salofalk 3g modified release granules PO OD - RESTARTED TODAY

Investigations:
• Colonoscopy (November 2022): Circumferential mucosal inflammation in proximal transverse colon with erythema and oedematous mucosa. 1 x 3mm sessile polyp removed. Histology: 3x2x2mm tubular adenoma with low grade dysplasia. Colonic biopsies: diffuse moderate active chronic inflammation with neutrophilic cryptitis, crypt abscesses and increased chronic inflammatory cells within lamina propria. No granulomas. Crypt architecture distortion from ascending colon. Rest of biopsies show normal large bowel mucosa.
• Blood tests (July 2023): CRP 2 (normal), FBC normal

Management Plan:
1. Restart Salofalk granules 3g PO OD
2. Surveillance colonoscopy as planned
3. IBD nurse or IBD consultant follow-up in 12 months
4. If flaring: double dose Salofalk and continue this dose for 6 weeks, contact IBD nurses

I had the pleasure of speaking on the telephone to Mr Chevin today in gastroenterology clinic on behalf of Dr Klimova.

Mr Chevin has a diagnosis of extensive colitis. The biopsies are more indicative of ulcerative colitis but the distribution is not typical of UC which is why I've classified him as inflammatory bowel disease unspecified.

I'm happy to hear that his bowel frequency is good, 1-2 times a day passing formed stool and he doesn't experience blood or mucus. He might experience one flare per year where he'll use his Salofalk but hasn't been using it the rest of the time.

He's otherwise fit and well and takes no other regular medicines. In his life more generally he works as a nightclub manager, always working nights. He has a wife and three children and reassuringly all of his children are well with no signs of colitis.

He did tell me that his father has been ill over the last three years with bowel cancer for which he needed operative management but reassuringly he's now in remission.

We discussed his own risk of bowel cancer which is increased because of his ulcerative colitis. He's going to attend a surveillance colonoscopy to keep an eye on his colon and to assess the activity in his inflammatory bowel disease and I've also encouraged him to go back onto the Salofalk granules which we know have a positive effect in decreasing his cancer risk in the future.

I look forward to seeing him back in clinic in a year's time but if he has any queries or concerns or if he's flaring he's more than welcome to get in contact with us sooner.

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Refined clinic letter Fri 20 June 2025 08:56

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