gayanin/gcd-noised · Datasets at Hugging Face

Unnamed: 0 int64 0 298	refs stringlengths 5 1.04k	trans stringlengths 2 921
200	all right okay	all right okay
201	it helps my pain	it helps my pain
202	are you taking that regularly	are you that regularly
203	id say so	id say so
204	have you noticed any stomach upset with that	have you noticed any stomach with that
205	i mean well i suppose i have to have this abdominal pain in my tummy so i dont know could that be could be connected to that	i well suppose i have to have this abdominal pain in my tummy so i know could that be could be connected to that
206	yeah possibly so we do find people here on long term nonsteroidal medications like diclofenac that kind of upset your stomach especially if youre not taking omeprazole or a medication like that with it so we need to be might need to address that do you have any insight or ideas about what might be causing your symptoms preferably the diarrhoea and the weight loss	yeah possibly do find people here on long term nonsteroidal medications like diclofenac that kind of upset your stomach especially if youre not taking or a medication like that with it so we need be might to address that do you have any insight or ideas about what might be your symptoms preferably the the weight loss
207	and well i suppose i just assumed thats my crohns with that was being watery but i dont know about but do you think it could be anything else	and well i suppose i just assumed thats crohns with that was being watery but i dont know about but do you think it could be else
208	so yeah i think theres a few different things it could be i noticed that youve not had a colonoscopy for quite some time in fact not said to you shortly after you were diagnosed so we might need to look at repeating that i think in the first instance will get some blood tests off to check in inflammatory markers and we need to send some samples of your stool off to make sure theres no infection and also send off a special stool test called fecal calprotectin and thats to look for inflammation in your bowel that might be related to the crohns disease i think depending on what those are well maybe decide on whether you need another camera test up up the tail end to have a look at the lining of the bowel so i think thats thats what we are doing just at that the moment how does that sound to you	so yeah i think theres a few different things it could be i noticed that youve not had a colonoscopy quite some time in fact not said to shortly after you were diagnosed so we need to look at repeating that i think in the first instance will some blood tests off check inflammatory markers and we need to send samples of stool off to make sure theres no infection and send off a special stool test called fecal and thats to for in your bowel that might be related to the crohns disease i think on what well maybe decide on whether you need camera test up tail end to a look at the of the bowel so i think thats thats what are doing just at that the how does that sound to you
209	yeah i mean yes yeah thats thats all right yeah i just yeah i didnt really think could be getting all these tests and things quite a lot to take in	i mean yes yeah thats thats all right yeah i just yeah i didnt really think could be getting all these tests and things quite a lot to take in
210	of course	of
211	but yeah i understand	but yeah i understand
212	any other questions	any other questions
213	yeah do you think i need to change my medication to something else	yeah do you think i need to change my medication to else
214	so one of the things we can do is to check the level of the medication in your blood called the adalimumab profile or checking the antibodies and the level of the drug but at the moment i wouldnt change you from your adalimumab just until weve got a bit more information about whats going on	so one of the things we can do is to check the level the medication in your blood called the adalimumab profile or checking the antibodies and the of the drug but at the i wouldnt change from your adalimumab just until weve got a bit more information about whats going on
215	okay you think i might need more surgery	okay you i might need more surgery
216	well again it depends a little bit on the investigations we might you know depending on what they show we might need to go on and get mri scan of your bowel just to have a look and make sure there arent any other points of narrowing in the bowel like you had last time if thats the case then we might need to look at surgery but thats a lot further down the line for a moment okay	well again it depends a bit on the investigations might you know depending on they show we might need to go on and get mri scan of bowel just to have look and make sure there arent other points of narrowing in the bowel like you had last time thats the then we might need to look at surgery but thats a lot further down the line for a moment okay
217	thank you	thank you
218	hello my names amy i am one of the gastroenterology doctors can i take your name	my names amy i am one of the gastroenterology doctors can i take your name
219	its rachel brown	its rachel
220	okay nice to meet you rachel so tell me why youve been referred to the gastroenterology clinic today	okay to meet you so tell me why youve been referred to the gastroenterology clinic
221	so for the past three months ive had a lot of diarrhoea and sometimes its quite bloody as well and its scaring me now	so for the past three months ive had a lot of diarrhoea sometimes bloody as well and its scaring me now
222	oh and have you ever had anything like that in the past	oh have you had anything like that in the past
223	over the past few years id say its been a bit iffy and intermittently having diarrhoea but its been worse over the past three months	over the past few years id say its been a bit iffy intermittently having diarrhoea but its been worse over the past three months
224	okay and that you are passing blood each time	okay and that you are passing blood each time
225	most times and its mixed with the stool and sometimes i see clots and things as well	most times and its with the stool and sometimes i see and things as well
226	okay have you noticed any mucus in your bowel motions	okay have you noticed any mucus in your bowel motions
227	yeah theres a lot of mucus	yeah theres a lot of mucus
228	and does that been the case for quite a few months as well	and does that been the case for a few months as
229	okay and hows your weight been	okay and hows your weight been
230	so ive lost quite a lot of weight recently my my parents are really worried about that	so ive lost a lot of weight my my parents are really worried about that
231	okay are you eating well	okay are you eating well
232	id say im eating well but i just i just dont seem to keep my weight up	say im eating well but i just i just dont seem to keep my weight up
233	and any abdominal pain or discomfort	any abdominal pain or discomfort
234	yeah i get quite a lot of abdominal pain its quite crampy just before i need to open my bowels	yeah i get quite a lot of abdominal pain its quite crampy just before i need to open my bowels
235	okay right and has the pain got worse do you think or stayed about the same	okay has the pain worse do you think stayed the same
236	i think its stayed about the same	i think its stayed about the same
237	and how often are you moving your bowels each day	and how are you moving your bowels each day
238	about six times a day id say	about six times a day id say
239	and is that been the case overnight as well or just during the day	and is that been the case overnight as well just during the day
240	id say usually have to get up about once a night	id say usually get up once a night
241	to go to the toilet	to go to the toilet
242	and any vomiting or problems with swallowing	and any vomiting problems with
243	and any other medical conditions that you have	and any other conditions you have
244	okay you are on any medications from your gp	okay you are any medications your gp
245	any allergies	any allergies
246	not that i know of	not that i know of
247	no okay and any family history of anything	no okay and any family history of anything
248	yeah my moms got ulcerative colitis	yeah my moms got ulcerative colitis
249	okay and is she well with that or is she on medications	and she well with that is she on medications
250	okay and so whats your understanding of of whats been going on so far	okay and so whats your understanding of of been on far
251	so im worried that ive got colitis as well	so im worried that ive got as well
252	does your moms experience make you more concerned about that or	does your make you concerned about that or
253	a little bit because she sometimes has a flare ups	a little bit because she sometimes has a flare ups
254	and that could be quite unwell with that so im quite worried but thats whats going to happen to me as well	and that could be quite unwell with so im quite worried but thats whats going to to me as well
255	okay so at the moment we need to take some stool cultures from you i think youve had some sent but we need to send a couple more just to exclude any infection we also need to arrange an urgent colonoscopy for you so that im sure your mom have had one of those before so its basically a camera test it goes into your bowel and has a look and we take photographs and take biopsies to try and diagnose you with what we think is inflammatory bowel disease okay there are a couple of different types of inflammatory bowel disease so one is called ulcerative colitis like your mom has and the other one is called crohns disease and so they are similar in many ways but there are key differences in terms of how we manage people so thats what well do at the moment for today well start you on something called pentesia which is to try and help reduce any inflammation in the bowel and then once we get a formal diagnosis from biopsies and things well hopefully aim to start you on some steroids to reduce the inflammation okay does that sound okay	okay so at the moment we need to take some stool cultures from you i think youve had some sent we need to send a couple more just to exclude any infection we also need to arrange an urgent colonoscopy for you so that im your have one of those before so its basically a camera goes into your bowel and has a look and we and take biopsies to try and diagnose you with what we is inflammatory bowel disease a couple of different types of inflammatory bowel disease so one is called ulcerative colitis like your has and the other one is called crohns disease so they are similar in many ways but are key differences in terms of how we manage people what well do at the moment for today well you on something called pentesia which is to try help reduce any inflammation in the bowel and then once we get a formal diagnosis from and well hopefully aim to start you on some steroids to the inflammation okay does that sound okay
256	yeah that sounds okay	that okay
257	do you have any questions about all of that or	do you have questions about all that or
258	so do i have to be on medications forever	so do i have to be on medications forever
259	so its very dependent on the patient or on the person who some people respond very well to initial therapy and they might remain well for years with a normal bowel habit and will kind of see you or speak to you from clinic you know maybe every six months for a year to see how youre getting on and decides if you can come off medication so some people stay on medication lifelong and some people manage to come off it	so its very dependent on the patient or on the person who some people respond very well to initial therapy and they might well for years with a normal bowel habit and will kind of you or speak to you from clinic you know maybe every six months for a year to see how youre getting on and decides if you can come off medication so some people stay on medication lifelong and some people manage to come it
260	okay that sounds fine	okay sounds fine
261	okay great	okay great
262	so ill go and arrange your series of investigations	ill go and arrange your series of investigations
263	hello my names amy im one of the gastroenterology doctors at the ibd clinic can i take your name	hello my names amy im of the gastroenterology doctors at the ibd clinic can i take your name
264	its rachel brown	its rachel brown
265	nice to meet you rachel so i know that youre quite well known to our clinic so we see every year or so but were seeing you slightly earlier than usual can you tell me why that is whats been going on	nice to meet you rachel so i know that youre quite well known to our clinic so we see year or so were seeing you slightly earlier than usual can you tell me why that is whats been on
266	so for the past kind of probably two months i noticed my bowels are going more frequently and its lot more watery than it used to be	so for the past kind of probably two noticed my bowels are going frequently and its lot more watery than it used to be
267	i havent noticed any blood but just the frequency is starting to become quite concerning	i havent noticed any blood but just the frequency is starting to become quite concerning
268	okay and if so have you noticed any blood at all or	okay and if so have you noticed blood at all or
269	no no blood but ive just been feeling very tired all the time quite lethargic	no no blood but ive been feeling very tired all the quite lethargic
270	okay and have you been to see your gp about any of this	okay and have you been to gp about any this
271	okay if you had any blood check recently or	okay if you had any blood check or
272	okay and so just tell me i know you are on adalimumab and how it has been for you	and so just tell me i you are on adalimumab and how it has been for you
273	so initially i felt that the adalimumab really made a big improvement kind of get my life back yeah now its i think its wearing off	so initially i felt that the really made a improvement kind of get my life back yeah now its i think its wearing off
274	okay and are you pretty good at taking it	okay and are you pretty good at taking it
275	yeah im good at taking it i always take it at every fortnight	yeah im good at it i always take it at every fortnight
276	okay and any abdominal pain	okay any abdominal pain
277	yeah i do get some pain but ive had that for quite a long time now	yeah do get some pain but ive had that for quite a time now
278	its been getting any worse recently	its been getting any worse recently
279	okay and any other medical conditions that you have	okay and any other medical conditions that you have
280	so ive got arthritis and hay fever and asthma as well	so ive got arthritis and hay and asthma as well
281	okay and are you on any medications for those things	and are you on any medications for those things
282	just ansaid for my arthritis	just ansaid for my arthritis
283	okay are you taking those regularly or	okay are you taking those regularly or
284	just kind of as when i need them i dont really like taking them	just kind of as when i need them i dont really like taking them
285	sure okay and do you have any sort of questions at the moment as to what might be going on or	sure and do you have any sort of questions at moment as to be going on or
286	what do you think is causing my symptoms of the moment	what do you think is causing my symptoms of the moment
287	so theres a few different things that could be going on one of them could be that as you sort of alluded to yourself that you might be coming your bodys not responding as well to the adalimumab so one of the things that well do today is check the levels of the drug in your body to make sure that your body is handling it as it should be it could also be that your crohns disease is a bit more active than usual so one of the things that we can do for that is check up fecal calprotectin which you will probably have had done before	so theres a few things that be going on one of them could be that as you sort of alluded to yourself that you might be coming your not well to the adalimumab so one of things that well do today is check the levels of drug in your body to make sure that your body is handling it as it should be it could be that your crohns disease is a bit more active than usual so one of the things that we can do for is check up fecal calprotectin which you will probably have had done before
288	and thats just a stool test to check the inflammation we also need to send some samples off to make sure theres no infection there as well and well do some bloods to make sure you are not a knee make or needing any sort of a placement of your electrolytes okay what how does that sound to you	and thats just a stool test to check the inflammation we also need to send some samples off to sure no infection there as well and well do some bloods to make sure you are not a make or needing any sort of a placement of your electrolytes okay what how that sound to you
289	you know that sounds fine im just worried that ill need to change my medication and ive been getting on quite well with the adalimumab	you know that sounds fine im just worried that ill need to change my medication and ive been getting on quite well with the adalimumab
290	so just a bit worried about that	so just a bit worried about that
291	must be a bit disappointing when its been working so well	must be a bit when its been working so well
292	okay i think well first of all get these basic investigations off it might be that we need to go on and get some more imaging of your abdomen in terms of mri scans or ct scans and also do a camera test or a colonoscopy to have a look at the tail end but well start with the basic investigations first and then we can decide about medication after does that sound okay	okay i think well first of all get these basic investigations off it might be that we need to go on some more imaging of your abdomen in terms of mri scans or ct scans and also do a camera test or a to have a look at the tail end but well start with basic investigations first and then we can decide about after does that okay
293	yeah that sounds fine just also worried that i might need more surgery again	yeah that sounds fine just also worried that i might need more surgery again
294	okay what what makes you worried about needing surgery in particular	okay what what makes you worried needing in particular
295	just took me quite a long time to recover last time	just took me quite a long time to recover last time
296	i just dont want more surgery	i just dont want more surgery
297	well it usually is a last resort for the people with inflammatory bowel disease so well do what we can with medication and hopefully you respond there are things we can do with your adalimumab to increase its dose or increase the frequency as well so there there are definitely other options other than surgery at the moment	well it usually is a last resort for the people with inflammatory bowel disease so well what we can with medication and hopefully you respond are things can do with adalimumab to increase its dose or increase the frequency as well so there there are definitely other options other than surgery at the moment
298	yeah that sounds fine thank you	yeah that sounds fine thank you

200

all right okay

201

it helps my pain

202

are you taking that regularly

are you that regularly

203

id say so

204

have you noticed any stomach upset with that

have you noticed any stomach with that

205

i mean well i suppose i have to have this abdominal pain in my tummy so i dont know could that be could be connected to that

i well suppose i have to have this abdominal pain in my tummy so i know could that be could be connected to that

206

yeah possibly so we do find people here on long term nonsteroidal medications like diclofenac that kind of upset your stomach especially if youre not taking omeprazole or a medication like that with it so we need to be might need to address that do you have any insight or ideas about what might be causing your symptoms preferably the diarrhoea and the weight loss

yeah possibly do find people here on long term nonsteroidal medications like diclofenac that kind of upset your stomach especially if youre not taking or a medication like that with it so we need be might to address that do you have any insight or ideas about what might be your symptoms preferably the the weight loss

207

and well i suppose i just assumed thats my crohns with that was being watery but i dont know about but do you think it could be anything else

and well i suppose i just assumed thats crohns with that was being watery but i dont know about but do you think it could be else

208

so yeah i think theres a few different things it could be i noticed that youve not had a colonoscopy for quite some time in fact not said to you shortly after you were diagnosed so we might need to look at repeating that i think in the first instance will get some blood tests off to check in inflammatory markers and we need to send some samples of your stool off to make sure theres no infection and also send off a special stool test called fecal calprotectin and thats to look for inflammation in your bowel that might be related to the crohns disease i think depending on what those are well maybe decide on whether you need another camera test up up the tail end to have a look at the lining of the bowel so i think thats thats what we are doing just at that the moment how does that sound to you

so yeah i think theres a few different things it could be i noticed that youve not had a colonoscopy quite some time in fact not said to shortly after you were diagnosed so we need to look at repeating that i think in the first instance will some blood tests off check inflammatory markers and we need to send samples of stool off to make sure theres no infection and send off a special stool test called fecal and thats to for in your bowel that might be related to the crohns disease i think on what well maybe decide on whether you need camera test up tail end to a look at the of the bowel so i think thats thats what are doing just at that the how does that sound to you

209

yeah i mean yes yeah thats thats all right yeah i just yeah i didnt really think could be getting all these tests and things quite a lot to take in

i mean yes yeah thats thats all right yeah i just yeah i didnt really think could be getting all these tests and things quite a lot to take in

210

of course

of

211

but yeah i understand

212

any other questions

213

yeah do you think i need to change my medication to something else

yeah do you think i need to change my medication to else

214

so one of the things we can do is to check the level of the medication in your blood called the adalimumab profile or checking the antibodies and the level of the drug but at the moment i wouldnt change you from your adalimumab just until weve got a bit more information about whats going on

so one of the things we can do is to check the level the medication in your blood called the adalimumab profile or checking the antibodies and the of the drug but at the i wouldnt change from your adalimumab just until weve got a bit more information about whats going on

215

okay you think i might need more surgery

okay you i might need more surgery

216

well again it depends a little bit on the investigations we might you know depending on what they show we might need to go on and get mri scan of your bowel just to have a look and make sure there arent any other points of narrowing in the bowel like you had last time if thats the case then we might need to look at surgery but thats a lot further down the line for a moment okay

well again it depends a bit on the investigations might you know depending on they show we might need to go on and get mri scan of bowel just to have look and make sure there arent other points of narrowing in the bowel like you had last time thats the then we might need to look at surgery but thats a lot further down the line for a moment okay

217

thank you

218

hello my names amy i am one of the gastroenterology doctors can i take your name

my names amy i am one of the gastroenterology doctors can i take your name

219

its rachel brown

its rachel

220

okay nice to meet you rachel so tell me why youve been referred to the gastroenterology clinic today

okay to meet you so tell me why youve been referred to the gastroenterology clinic

221

so for the past three months ive had a lot of diarrhoea and sometimes its quite bloody as well and its scaring me now

so for the past three months ive had a lot of diarrhoea sometimes bloody as well and its scaring me now

222

oh and have you ever had anything like that in the past

oh have you had anything like that in the past

223

over the past few years id say its been a bit iffy and intermittently having diarrhoea but its been worse over the past three months

over the past few years id say its been a bit iffy intermittently having diarrhoea but its been worse over the past three months

224

okay and that you are passing blood each time

225

most times and its mixed with the stool and sometimes i see clots and things as well

most times and its with the stool and sometimes i see and things as well

226

okay have you noticed any mucus in your bowel motions

227

yeah theres a lot of mucus

228

and does that been the case for quite a few months as well

and does that been the case for a few months as

229

okay and hows your weight been

230

so ive lost quite a lot of weight recently my my parents are really worried about that

so ive lost a lot of weight my my parents are really worried about that

231

okay are you eating well

232

id say im eating well but i just i just dont seem to keep my weight up

say im eating well but i just i just dont seem to keep my weight up

233

and any abdominal pain or discomfort

any abdominal pain or discomfort

234

yeah i get quite a lot of abdominal pain its quite crampy just before i need to open my bowels

235

okay right and has the pain got worse do you think or stayed about the same

okay has the pain worse do you think stayed the same

236

i think its stayed about the same

237

and how often are you moving your bowels each day

and how are you moving your bowels each day

238

about six times a day id say

239

and is that been the case overnight as well or just during the day

and is that been the case overnight as well just during the day

240

id say usually have to get up about once a night

id say usually get up once a night

241

to go to the toilet

242

and any vomiting or problems with swallowing

and any vomiting problems with

243

and any other medical conditions that you have

and any other conditions you have

244

okay you are on any medications from your gp

okay you are any medications your gp

245

any allergies

246

not that i know of

247

no okay and any family history of anything

248

yeah my moms got ulcerative colitis

249

okay and is she well with that or is she on medications

and she well with that is she on medications

250

okay and so whats your understanding of of whats been going on so far

okay and so whats your understanding of of been on far

251

so im worried that ive got colitis as well

so im worried that ive got as well

252

does your moms experience make you more concerned about that or

does your make you concerned about that or

253

a little bit because she sometimes has a flare ups

254

and that could be quite unwell with that so im quite worried but thats whats going to happen to me as well

and that could be quite unwell with so im quite worried but thats whats going to to me as well

255

okay so at the moment we need to take some stool cultures from you i think youve had some sent but we need to send a couple more just to exclude any infection we also need to arrange an urgent colonoscopy for you so that im sure your mom have had one of those before so its basically a camera test it goes into your bowel and has a look and we take photographs and take biopsies to try and diagnose you with what we think is inflammatory bowel disease okay there are a couple of different types of inflammatory bowel disease so one is called ulcerative colitis like your mom has and the other one is called crohns disease and so they are similar in many ways but there are key differences in terms of how we manage people so thats what well do at the moment for today well start you on something called pentesia which is to try and help reduce any inflammation in the bowel and then once we get a formal diagnosis from biopsies and things well hopefully aim to start you on some steroids to reduce the inflammation okay does that sound okay

okay so at the moment we need to take some stool cultures from you i think youve had some sent we need to send a couple more just to exclude any infection we also need to arrange an urgent colonoscopy for you so that im your have one of those before so its basically a camera goes into your bowel and has a look and we and take biopsies to try and diagnose you with what we is inflammatory bowel disease a couple of different types of inflammatory bowel disease so one is called ulcerative colitis like your has and the other one is called crohns disease so they are similar in many ways but are key differences in terms of how we manage people what well do at the moment for today well you on something called pentesia which is to try help reduce any inflammation in the bowel and then once we get a formal diagnosis from and well hopefully aim to start you on some steroids to the inflammation okay does that sound okay

256

yeah that sounds okay

that okay

257

do you have any questions about all of that or

do you have questions about all that or

258

so do i have to be on medications forever

259

so its very dependent on the patient or on the person who some people respond very well to initial therapy and they might remain well for years with a normal bowel habit and will kind of see you or speak to you from clinic you know maybe every six months for a year to see how youre getting on and decides if you can come off medication so some people stay on medication lifelong and some people manage to come off it

so its very dependent on the patient or on the person who some people respond very well to initial therapy and they might well for years with a normal bowel habit and will kind of you or speak to you from clinic you know maybe every six months for a year to see how youre getting on and decides if you can come off medication so some people stay on medication lifelong and some people manage to come it

260

okay that sounds fine

okay sounds fine

261

okay great

262

so ill go and arrange your series of investigations

ill go and arrange your series of investigations

263

hello my names amy im one of the gastroenterology doctors at the ibd clinic can i take your name

hello my names amy im of the gastroenterology doctors at the ibd clinic can i take your name

264

its rachel brown

265

nice to meet you rachel so i know that youre quite well known to our clinic so we see every year or so but were seeing you slightly earlier than usual can you tell me why that is whats been going on

nice to meet you rachel so i know that youre quite well known to our clinic so we see year or so were seeing you slightly earlier than usual can you tell me why that is whats been on

266

so for the past kind of probably two months i noticed my bowels are going more frequently and its lot more watery than it used to be

so for the past kind of probably two noticed my bowels are going frequently and its lot more watery than it used to be

267

i havent noticed any blood but just the frequency is starting to become quite concerning

268

okay and if so have you noticed any blood at all or

okay and if so have you noticed blood at all or

269

no no blood but ive just been feeling very tired all the time quite lethargic

no no blood but ive been feeling very tired all the quite lethargic

270

okay and have you been to see your gp about any of this

okay and have you been to gp about any this

271

okay if you had any blood check recently or

okay if you had any blood check or

272

okay and so just tell me i know you are on adalimumab and how it has been for you

and so just tell me i you are on adalimumab and how it has been for you

273

so initially i felt that the adalimumab really made a big improvement kind of get my life back yeah now its i think its wearing off

so initially i felt that the really made a improvement kind of get my life back yeah now its i think its wearing off

274

okay and are you pretty good at taking it

275

yeah im good at taking it i always take it at every fortnight

yeah im good at it i always take it at every fortnight

276

okay and any abdominal pain

okay any abdominal pain

277

yeah i do get some pain but ive had that for quite a long time now

yeah do get some pain but ive had that for quite a time now

278

its been getting any worse recently

279

okay and any other medical conditions that you have

280

so ive got arthritis and hay fever and asthma as well

so ive got arthritis and hay and asthma as well

281

okay and are you on any medications for those things

and are you on any medications for those things

282

just ansaid for my arthritis

283

okay are you taking those regularly or

284

just kind of as when i need them i dont really like taking them

285

sure okay and do you have any sort of questions at the moment as to what might be going on or

sure and do you have any sort of questions at moment as to be going on or

286

what do you think is causing my symptoms of the moment

287

so theres a few different things that could be going on one of them could be that as you sort of alluded to yourself that you might be coming your bodys not responding as well to the adalimumab so one of the things that well do today is check the levels of the drug in your body to make sure that your body is handling it as it should be it could also be that your crohns disease is a bit more active than usual so one of the things that we can do for that is check up fecal calprotectin which you will probably have had done before

so theres a few things that be going on one of them could be that as you sort of alluded to yourself that you might be coming your not well to the adalimumab so one of things that well do today is check the levels of drug in your body to make sure that your body is handling it as it should be it could be that your crohns disease is a bit more active than usual so one of the things that we can do for is check up fecal calprotectin which you will probably have had done before

288

and thats just a stool test to check the inflammation we also need to send some samples off to make sure theres no infection there as well and well do some bloods to make sure you are not a knee make or needing any sort of a placement of your electrolytes okay what how does that sound to you

and thats just a stool test to check the inflammation we also need to send some samples off to sure no infection there as well and well do some bloods to make sure you are not a make or needing any sort of a placement of your electrolytes okay what how that sound to you

289

you know that sounds fine im just worried that ill need to change my medication and ive been getting on quite well with the adalimumab

290

so just a bit worried about that

291

must be a bit disappointing when its been working so well

must be a bit when its been working so well

292

okay i think well first of all get these basic investigations off it might be that we need to go on and get some more imaging of your abdomen in terms of mri scans or ct scans and also do a camera test or a colonoscopy to have a look at the tail end but well start with the basic investigations first and then we can decide about medication after does that sound okay

okay i think well first of all get these basic investigations off it might be that we need to go on some more imaging of your abdomen in terms of mri scans or ct scans and also do a camera test or a to have a look at the tail end but well start with basic investigations first and then we can decide about after does that okay

293

yeah that sounds fine just also worried that i might need more surgery again

294

okay what what makes you worried about needing surgery in particular

okay what what makes you worried needing in particular

295

just took me quite a long time to recover last time

296

i just dont want more surgery

297

well it usually is a last resort for the people with inflammatory bowel disease so well do what we can with medication and hopefully you respond there are things we can do with your adalimumab to increase its dose or increase the frequency as well so there there are definitely other options other than surgery at the moment

well it usually is a last resort for the people with inflammatory bowel disease so well what we can with medication and hopefully you respond are things can do with adalimumab to increase its dose or increase the frequency as well so there there are definitely other options other than surgery at the moment

298

yeah that sounds fine thank you