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What condition did a 74-year-old man with recurrent abdominal cramping, bloody stools, and fatigue likely present with?

  1. Giardiasis

  2. Irritable bowel syndrome

  3. Diverticulitis

  4. Ulcerative colitis

The correct answer is: Ulcerative colitis

The symptoms described for the 74-year-old man—recurrent abdominal cramping, bloody stools, and fatigue—are highly indicative of ulcerative colitis. This condition is a type of inflammatory bowel disease (IBD) that primarily affects the colon and rectum. It is characterized by continuous inflammation of the colonic mucosa, leading to symptoms such as abdominal pain, cramps, rectal bleeding, and often extreme fatigue due to the body's inflammatory response and potential anemia from blood loss. The presence of bloody stools is particularly significant because it is a hallmark symptom of ulcerative colitis, distinguishing it from other gastrointestinal disorders. Furthermore, the recurrent nature of the cramping fits well with the relapsing-remitting nature of ulcerative colitis flare-ups, where symptoms can improve and then worsen periodically. While giardiasis can cause gastrointestinal issues, it typically presents with diarrhea, which may be greasy and foul-smelling, rather than bloody stools, making it less likely in this case. Irritable bowel syndrome (IBS) can also present with abdominal cramping but does not usually result in bloody stools or significant fatigue. Diverticulitis, while it can cause abdominal pain and occasionally bleeding, is often accompanied by localized tenderness and can present differently