Bolus Emphysema Case Study

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CHIEF COMPLAINT: Followup.

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This is a 46-year-old Afro-American male who returns to the clinic after last being seen in 08/2017 for constipation and abdominal bloating. He has a history of a mixed connective tissue disorder and bolus emphysema. When I saw the inmate in 08/2017, he had reported to me constipation, bloating, and intestinal gas. His history also suggested that he had a colonoscopy done elsewhere in 01/2015 that was normal. I had recommended a colonic motility study, Sitzmarks capsule. This is an ingested capsule that contains 24 radiopaque markers that were ingested on day one, by the inmate then five days later an abdominal x-ray is obtained. That x-ray that was obtained was negative for any retained radio opaque markers, this suggests normal colonic function, yet despite this test, the inmate continues to complain vehemently of constipation, bloating, and gas. He has taken multiple laxatives and none of these are effective. He is asking me for alternative therapies. …show more content…

We have documented that there is no weight loss, nausea, or vomiting. That despite his complaints of not being able to eat, he has not lost weight. He denies any blood per rectum. On physical examination, his abdomen is also benign, it is slightly rounded but firm. I do not detect any mass and there is no guarding or

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