Stress as a Trigger for Colitis: A 57-Year-Old Woman's Medical Case Study
A 57-year-old woman sought medical attention after experiencing lower abdominal pain and increased bowel movements for one month, followed by one day of rectal bleeding. Based on her clinical presentation and diagnostic findings, she was diagnosed with colitis. Following an 8-day hospitalization involving intravenous and oral treatments, her symptoms significantly improved, and she was discharged without complications.
Patient Profile
- Age: 57
- Gender: Female
- Medical History: Cervical spondylosis
- Hospital: The First Affiliated Hospital of China Medical University
- Admission Date: June 2020
- Treatment: Intravenous somatostatin, levofloxacin, glucose saline solution, and oral Fengliao Changweikang Granules
- Recovery: Symptoms of abdominal pain, diarrhea, and rectal bleeding resolved after treatment
Initial Consultation and Diagnosis
The patient reported experiencing significant emotional stress due to recent family conflicts. One month prior to admission, she began experiencing lower abdominal pain and frequent bowel movements, which she initially ignored. On the day before her visit, she noticed rectal bleeding. Upon examination, her blood pressure was elevated at 160/100 mmHg. Abdominal palpation revealed tenderness in the lower left quadrant, but no rebound tenderness or organ enlargement. Bowel sounds were active. Blood tests showed a white blood cell count of 12.2×10^9/L, indicating inflammation. A colonoscopy revealed scattered patches of congestion, edema, and erosion in the descending colon approximately 40 cm from the anus, with minor bleeding. These findings confirmed a diagnosis of colitis, prompting hospital admission.
Therapeutic Approach and Patient Care
Due to the patient's anxiety regarding rectal bleeding, early communication and emotional support were provided to ensure cooperation. A treatment plan was developed focusing on hemostasis, anti-inflammatory action, and hydration. Intravenous somatostatin was administered to reduce gastrointestinal secretions and control bleeding. Levofloxacin was used for its antibacterial properties, while glucose saline solution addressed fluid balance. Additionally, the patient received oral Fengliao Changweikang Granules to alleviate abdominal discomfort, bloating, and diarrhea. Dietary recommendations included a bland liquid diet during treatment, along with adequate rest and hydration.
Positive Outcomes After Treatment
After five days of medication, the patient's abdominal pain decreased and her bowel movements normalized from 3–4 per day to once daily. A follow-up blood test showed white blood cell levels had returned to normal, and rectal bleeding ceased. By the eighth day of hospitalization, she was free of abdominal pain and bloating, slept well, and resumed normal eating. Physical examination revealed no abdominal tenderness or abnormal bowel sounds. She was discharged and advised to continue oral therapy, with a follow-up appointment scheduled for one month later.
Post-Treatment Recommendations
To support long-term recovery, the patient was advised to:
1. Recognize that colitis may require ongoing management, including regular medical check-ups and adherence to prescribed medications.
2. Gradually resume physical activity after full recovery, such as walking, jogging, or light exercise, to improve overall health.
3. Manage emotional stress, as psychological strain can contribute to flare-ups. Family support and professional counseling may be beneficial in maintaining mental well-being.
Reflections on the Case
This case highlights the importance of distinguishing colitis from more serious conditions like colorectal cancer. Multiple CT scans were performed to rule out any space-occupying lesions, and colonoscopy confirmed the diagnosis. It is crucial for individuals experiencing unexplained abdominal pain, changes in bowel habits, or rectal bleeding to seek timely medical evaluation to prevent complications.