A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment –
**Core Concept**
The patient's presentation of lower gastrointestinal bleeding and sigmoidoscopy findings of ulcers in the sigmoid region, coupled with biopsy results showing flask-shaped ulcers, is suggestive of amoebic colitis, a condition caused by the protozoan parasite Entamoeba histolytica.
**Why the Correct Answer is Right**
The correct diagnosis of amoebic colitis is supported by the presence of flask-shaped ulcers, which are a hallmark of this condition. These ulcers are caused by the amoebae's destructive action on the colonic mucosa, leading to the characteristic flask-shaped morphology. Treatment with metronidazole is the standard approach for amoebic colitis, as it targets the amoebic cysts and trophozoites, effectively reducing the severity of symptoms and promoting healing.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because steroids are not the primary treatment for amoebic colitis. While they may be used in some cases to reduce inflammation, they do not address the underlying cause of the condition.
**Option B:** This option is incorrect because ciprofloxacin is an antibiotic effective against bacterial infections, but it is not the first-line treatment for amoebic colitis, which is caused by a protozoan parasite.
**Option C:** This option is incorrect because antacids are used to neutralize stomach acid and are not effective in treating the underlying cause of amoebic colitis.
**Clinical Pearl / High-Yield Fact**
The presence of flask-shaped ulcers in the sigmoid region should prompt consideration of amoebic colitis as the underlying diagnosis, and treatment with metronidazole should be initiated promptly to prevent complications and promote healing.
**Correct Answer:** C. Metronidazole.