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Diarrhoea and duodenal disease
  1. Jennifer A Nielsen1,
  2. James J Weber2,
  3. Donna J Lager3
  1. 1 Division of Research, ProPath, Dallas, Texas, USA
  2. 2 Division of Research, Texas Digestive Disease Consultants, Southlake, Texas, USA
  3. 3 Gastrointestinal Pathology Division, ProPath, Dallas, Texas, USA
  1. Correspondence to Dr Donna J Lager, Gastrointestinal Pathology Division, ProPath, 1355 River Bend Dr., Dallas, TX 75247, USA; donna.lager{at}

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A 27-year-old Caucasian male presented with a one-month history of diarrhoea, severe abdominal cramping, heartburn and weight loss. The symptoms began right after breakfast in the morning and continued with 3–4 watery stools throughout the day, but none during the night. Spicy foods, alcoholic beverages and excessive water intake seemed to exacerbate the pain, but soda seemed to alleviate it. The patient denied use of antibiotics, antispasmodics, or antihypertensive drugs, and drank minimal milk. The patient denied any recent international travel or contact with diapers or ill persons but confirmed that the symptoms started about a week after a river trip. There was no known family history of GI disease. Endoscopically, the …

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