Crampy Lower Abdominal Pain in Medicine / Internal Medicine — 28yo Man | Gastroenterology | SMLE Q#11541
SMLE Question #11541
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 28-year-old man has 2 months of bloody, mucoid diarrhea (6–8/day) with crampy lower abdominal pain relieved by defecation, urgency, and occasional tenesmus. He has lost 3 kg and looks mildly pale. Digital rectal examination shows blood and mucus. Colonoscopy shows continuous erythema, friability, and superficial ulcerations starting at the rectum and extending proximally. Biopsies show chronic inflammation with crypt abscesses limited to the mucosa and submucosa. What is the most likely diagnosis?
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