45year male with ltered bowel habits




A 45yaer mle teacher by occupation came to op complaining of altered bowel habits from 5 years 
Pain and burning sensation after taking spicy food
Loss fo appetite from March 2022
Wt loss 15ks in 5months
HopI pt was apparently asymptomatic 5years back developed constipation followed by diarrhoea
Pian abdomen after taking spicy food so stopped taking spicy foods and nonveg intake since then 
Personal history
Appetite decreased
Diet mixed diet
Sleep normal
Addictions chronic tobbaco nd pan chewer since 19years ten times a day
Bladder movements regular
Bowel altered bowel movements
Past history is.an hypertensive from 2019 is on tab metxl 12.5 mg po od
He has excessive fear of staying alone in aroom nd to go out on a road for which he is taking tab amitriptyline
Is not a k/c/o dm sthmatic epilepsy cad
General examination
Pt c/c/c 
PR 84bpm
Bp140/90mmof hg
Cvs s1s2 heared
Rs Bae present
P/a soft
CNS NAD
Systemic examination
Per abdomen soft non tender
Investigations 

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