Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Constipation, Diarrhoea, Electrocardiogram normal, Gastrointestinal wall thickening, Influenza A virus test negative
Clinical narrative: COLITIS      "I'm having a colitis flare up" Symtoms started friday ? Nausea, Vomiting, Diarrhea     Source of Information:  Patient and Available medical record   History of Present Illness:  This is a 33y.o. female with PMH significant for IBD, endometriosis, asthma, and prior DVT not on anticoagulation who presented to the hospital for 5-day history of abdominal pain with diarrhea, nausea, and vomiting. Patient is a poor historian, and history was corroborated with chart review.  Patient was recently at Hospital from 1/20?1/24 for abdominal pain with nausea and vomiting.  At that time she was found to be Covid positive and constipated.  Her symptoms improved with bowel regimen where she was given MiraLAX and Colace.  She states that on discharge she was feeling well until 1/28 when she developed diarrhea followed by abdominal pain.  She describes the abdominal pain as generalized and constant.  Nothing makes it better or worse.  She states that she has had multiple loose bowel movements since Friday and is unable to enumerate how many.  Has had 3 episodes of emesis since Friday as well which she relates to her abdominal pain.  Patient states that this feels more severe than her prior UC flares.  Does note that she gets nauseous from her abdominal pain which then leads to emesis.  Has not had any recent travel anywhere.  Does note that her mom who she lives with also started experiencing diarrhea yesterday.  Denies any fevers or chills.  Most of her diet consists of outside food, she states that she ate chicken the night before she felt ill.  Patient is maintained on mesalamine for her UC, however does not routinely follow with a gastroenterologist.  Her last colonoscopy was in 2018 which demonstrated proctosigmoid UC.  She has previously required a partial colectomy due to both her UC and endometriosis.  Patient denies any melena or hematochezia.  Patient states that she was given an antibiotic while she was at Hospital, however upon chart review no records found.  She is unable to state where she was given.  Patient has routinely good appetite and is able to eat and drink, however states that 30 minutes after she eats she has to have a bowel movement and vomits.  Patient without fevers, chills, chest pain, shortness of breath.   Patient has had an extensive surgical history due to her endometriosis and ulcerative colitis.  Previously patient received a hysterectomy with a right salpingectomy and excision of bladder endometriosis.    Patient currently smokes 2-3 black mild cigars daily, and has had a 10-pack-year smoking history prior.  Denies any alcohol or recreational drug use.  Currently lives at home with her mom.  No pets.   Vitals on presentation to ED: 104/60, 92 HR, 16 RR, 98.1 F, 100%  SpO2 on RA.  EKG showing NSR.  CT abdomen pelvis showing circumferential wall thickening of the rectum with perirectal inflammatory changes.  Patient given 1 L normal saline, ketamine, Protonix, Compazine, and Benadryl.  She did receive fentanyl 25 mcg for pain.  GI consulted.