6 Weeks Of Worsening in Medicine / Internal Medicine — 28yo Man | Gastroenterology | SMLE Q#17726
SMLE Question #17726
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-IM-GI-CRD-THER-001
Last updated: February 2026
A 28-year-old man with a 6-year history of Crohn disease presents with 6 weeks of worsening crampy abdominal pain and 5–7 loose stools/day, sometimes with mucus and minimal blood. He has taken oral prednisone 40 mg daily for 3 weeks with good adherence and no improvement. Colonoscopy shows patchy colitis with intervening normal mucosa. Stool testing is negative for Clostridioides difficile. He has no perianal disease and no clinical features of bowel obstruction. What is the most appropriate next step in management to add?
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