The mother's family all have bowel complaints but no cancer or inflammatory bowel disease. Physical Examination L.H. is a smartly-dressed, obviously intelligent young woman. Her symptoms are initially described with relish and colourful adjectives. However, discussion of her personal life is accompanied by tears and an air of despair. She says that she has never discussed these matters with anyone before.
General examination indicates no anaemia, jaundice, weight loss, thyroid disease or malnutrition.
Abdominal examination reveals cholecystectomy and appendectomy incisional scars. The abdomen seems tender all over, especially on the left side. The sigmoid colon can be palpated and is cord-like and tender. There are no masses or enlarged organs. Digital rectal examination is negative.