So next patient is colin wilkinson alpha41816 diagnosis probable naproxen related enteropathy february 2025 other medical problems calr positive myelofibrosis april 2021 gout other medical problems medications list ruxolitinib that's r u x o l I t n I b 15 mg twice per day and acyclovir investigations blood tests july 2025 normal lft is normal apart from high protein and high globulin white 17.5 with neutrophils 8.5 monocytes 2.45 eosinophils naught 0.42 and basophils naught 0.38 hemoglobin 130 colonoscopy february 2025 moderate mucosal erythema and friability of the whole: deep ulcerations in rectosigmoid and sigmoid: normal looking terminal ileum bowel prep suboptimal histology small intestinal biopsies with preserved villous architecture normal cellular lamina propria no organisms displayed in your malignancy colonic biopsies demonstrating marked crypt architectural distortion throughout in association with moderate chronic inflammation of the lamina propria no active inflammation or infective organisms previously discharged from clinic may 2025 hi my name is doctor rob miller I'm 1 of the gastroenterology here at daraford how are you have I caught you at a reasonable time good fine I was reading your letters and you can see you've had a bit of a year of it really with with the myelofibrosis on treatment and then that colonoscopy back in february that showed some inflammation in the: and then we all thought thought that was because of anti inflammatories is that right naproxen and you've stopped those and are you feeling better no problems since stopping them fantastic I think we plan to discharge you from clinic when we last spoke to you in may but clearly that didn't happen and you're back on my list today but everything seems to be okay you're quite happy fantastic I'm this is gastroenterology yeah no don't worry it sounds like you see a few doctors so it's entirely reasonable but yeah I don't I don't I think what we found at colonoscopy could easily be attributed to the anti inflammatories you're on and it's reassuring that you've stopped taking them and feel better I don't think there's anything else we need to do so I will I'll discharge you from clinic if that's alright but we're always here if you need us if you have worse symptoms or anything like that get back in contact with us and we can see you again sound good no worries nice to talk to you sorry it was brief but I hope you're doing okay alright talk to you soon bye bye so I plan discharge from clinic did you be had the pleasure of speaking on the telephone to mister wilkinson on behalf of professor lewis in gastroenterology clinic today full stop <\n\n> I'm reassured to hear he's been entirely well since stopping his naproxen and colchicine which we have attributed his endoscopic findings of significant colitis to full stop his diarrhea settled his bowel habit is now regular and he continues to be off these medicines full stop I've explained that we didn't suggest not starting these medicines again full stop <\n\n> He has no concerns and is feeling well in himself and so I'll discharge him from gastroenterology clinic today full stop it looks like the plan from when he was last seen in clinic in may was to discharge him however it doesn't appear this happened so I will discharge him from clinic today but he's always welcome to get back in contact with us via yourself or our secretaries if he wishes to see us again full stop new york city