18 yrs male pain lower abd. and both iliac fossa since 1 month taking ceftriaxone 1 gm IV BD, ornof tab,pan 40 tramadol , albendazole, suspension sucral,syr neeri,cystone,veltam 0.4 no benefit no RIF tenderness suggest ur opinions plz

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Pain in both iliac fossa is self explanatory on lt side there is nephrolethiasis stone is of large size hence as and when movement of the stone happens it is referred pain in lt side . Now usg is indicating paramesantric lymphadenopathy which is suggested to be inflammatory in nature with thickened colon on rt side suggestive of chr infection .so investigations required will be cbc esr urine bsl ct abdomen .also take detail history of fever wt loss and nature of motions that is loose ans hard alternately or associated with gripping pain go for 3samples of stool examination and for occult blood also suggest mt test sos biopsy of lymphnode as well as colon.

A colonoscopy is advised followed by CECT abdomen . D/D - Inflammatory bowel disease Irritable bowel syndrome Intestinal tuberculosis

IBS IS DIGNOSIS OF EXCLUSION AS USG IS SHOWING COLITIS ( PATHOLOGY ), THEN FROM WE CAN THINK IBS? OFLOXACIN IV ( MAX DOSE 800 MG/DAY) SHOULD BE GIVEN ALONG WITH CEFTRIAXONE DONT GIVE EXTRA MEDICINES LIKE ALBNDAZOLE IS SINGLE DOSE CAN OMIT NEERI,CYSTON,VELTU,TRAMADOL,SUCRAL GIVE ONLY ANTISPASMODIC WITH PPI IF NOT IMPROVE THEN CECT ABDOMEN AND COLONOSCOPY IS LAST IX TO GUIDE MX

Get down patient to Nitazoxanide with levofloxacin PPI with domperidone. Rest neeri and cystone If abdominal pain occurred then try dortaverine 80 mg. Follow up after 1 week

Should do CECT abdomen with oral contrast followed by Colonoscopy ...

It's a case of IBS.it needs confirmation by sonography.

Advised colposcopy

Any complain of fever or weight loss?

No madam CBC, ESR ,Mt awaited
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Case of IBS. With Gastroentritis.First put your pt upon therapeutic then after therapy sonography should be done for futher confirmation.

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