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The letter highlights weight loss, poor appetite, positive fecal occult blood, elevated white cell count, raised ESR/CRP, and abdominal tenderness on exam without hepatosplenomegaly. Differential considerations include inflammatory bowel disease, particularly Crohn’s, supported by family history. Lifestyle counseling includes complete smoking cessation and medication/allergy background.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/newton-gastroenterology-referral-letter/199438/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/newton-gastroenterology-referral-letter/199438.png","ImageObject",300,407,{"name":92,"@type":93},"Cart","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-19","2026-09-04",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"What advice and medication/allergy details were provided?","Question",{"text":112,"@type":113},"He was counseled on IBD and advised to completely stop smoking 10–15 cigarettes per day. He has no known allergies and reports only using ibuprofen as needed.","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},199438,1788505981,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":131,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":67,"update_tm":121,"read_time":81},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Dr. Jack Thomas Gastroenterology Department City Hospital  \nMain Road Stillwater  \n21. February, 2015  \nDear Dr Thomas,  \nRe: Patrick Newton, 25 years old  \nI would be grateful for your assessment and advice on the diagnosis of this patient who has symptoms and signs suggestive of inflammatory bowel disease.  \nMr. Newton presented today with a four-month history of chronic mild diarrhoea and intermittent R lower quadrant abdominal pain. He has had poor appetite with weight loss of 3kg in the last four months, and has become increasingly embarrassed about his symptoms which have not responded to dietary modification and OTC medications, and have even caused him to withdraw from regular sport activities.  \nOn examination today, he is afebrile with significant findings confined to a generally tender abdomen without hepatosplenomegaly, elevated white cell count ( 11. 1), decreased red cell count (4.0) , elevated ESR and CPR, and positive FOB.  \nMy tentative differential diagnosis is either IBD or Crohn’s , especially in light of his family history ( his uncle has Crohn’s) . Mr Newton has therefore been counseled on IBD and advised to completely stop his current habit of smoking 10-15 cigarettes a day. He has no known allergies and only takes ibuprofen when needed.  \nThank you in advance for your intervention, and do not hesitate to contact me if you have any further queries.  \nKind regards, Doctor.  \nBody 194 words  \nTime 5 + 28 minutes","cbCaiiRutToCv3mB","https://ap.wps.com/l/cbCaiiRutToCv3mB","pdf",225227,"English","# Clinical Referral Request\n## Presenting Symptoms and History\n## Examination and Laboratory Findings\n## Differential Diagnosis and Counseling","[{\"question\":\"What advice and medication/allergy details were provided?\",\"answer\":\"He was counseled on IBD and advised to completely stop smoking 10–15 cigarettes per day. He has no known allergies and reports only using ibuprofen as needed.\"}]","Newton - Gastroenterology Referral Letter | PDF"]