Opinion ID: 4517908
Heading Depth: 4
Heading Rank: 2

Heading: Ionia Family Practice

Text: A second series of medical records, dated from 2013 to 2015, documents Emard’s appointments at Ionia Family Practice. Emard was first seen at Ionia Family Practice for back pain and a range of gastrointestinal issues. In one visit, for instance, Emard reported that he had experienced three-to-five episodes of diarrhea daily for the past five years, although the results of his gastrointestinal test proved normal at the time. He was referred in 2015 to a gastroenterologist, Dr. Allan Coates, who reported that “evidence of erosions throughout the terminal ileum and biopsies were felt to be possibly consistent with Crohn’s disease.” Dr. Coates’s records reflect diagnoses of gastroesophageal reflux disease (GERD) and possible Crohn’s disease. In June 2014, a Physician Assistant at the Ionia Family Practice diagnosed Emard with lumbago. Notes from the clinic further show that Emard underwent a second MRI exam in 2014. The exam revealed that Emard’s spinal injuries had remained relatively stable. Emard, however, reported that his pain had worsened and that his symptoms were severe. He continued to be seen for back pain, which he rated as “moderate to severe,” in several subsequent visits in 2014, but his physical-exam results remained normal. Emard was prescribed pain medication and muscle relaxers as treatment. His records show that he denied experiencing anxiety or depression during these visits, and his psychiatric evaluations remained normal.