Shannon Williams is a 33-year old female who presented to her physician a chief complaint of abdominal pain and diarrhea.

Shannon Williams is a 33-year old female who presented to her physician a chief complaint of abdominal pain and diarrhea. She said that she had felt well until one month ago when she began suffering from crampy abdominal pain in the right lower quadrant. The pain was worse after meals. When Shannon suffered from the cramps she noticed that her abdomen became distended. Her pain improved under two conditions: if she did not eat and following bowel movements. She said that her stools were watery and occurred about six times per day. Shannon also complained of fatigue, a ten-pound weight loss, and low-grade fevers. She did not drink milk or consume many dairy products except for yogurt, which did not seem to bother her. Shannon stated that she had not travelled recently outside her home of Portland, Oregon and that she was not a hiker.

Shannon Williams has an identical twin who also had some intermittent abdominal pain and diarrhea, but had not sought medical attention.

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