Nocturnal diarrhea is usually present when daytime diarrhea is severe. Rectal tenesmus may be severe, and anal incontinence may be present. Cramping lower abdominal pain often occurs but is generally mild. Anorexia, malaise, weakness and fatigability may also be present. A history of intolerance to dairy products can often be obtained, and there is a tendency toward remissions and exacerbations.

Fever, weight loss and evidence of toxemia vary with the severity of the disease. Abdominal tenderness is generally mild and occurs without signs of peritoneal irritation. Abdominal distention may present in the fulminating form and is a poor Prognostic sign. Rectal examination may show perianal irritation, fissures, hemorrhoids, fistulas and abscesses.

DIAGNOSIS
Essentials of diagnosis in Western medicine. Bloody diarrhea with lower abdominal cramps.
Mild abdominal tenderness, weight loss, fever.
Anemia: No stool pathogens.

Specific X-ray and sigmoidoscopic abnormalities.X-ray findings: As shown by X-ray, the involvement may he regional or generalized and may vary from irritability and fuzzy margins to pseudopolyps, decreased size of colon, shortening and narrowing of the lumen, and loss of haustral markings. When the disease is limited to the rectosigmoid area, the barium enema may even be normal.

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