An unsuspected cause of chronic diarrhoea

A 45-year-old Italian man, living in Italy, was admitted to our clinic with a 6-month history of chronic diarrhoea (soft stool, 3–4 times/day), iron-deficiency anaemia, recurrent abdominal pain, weight loss (10 kg over 6 months) and weakness. Examination was normal apart from moderate pallor and a soft but diffusely tender abdomen. He was not febrile: there was no pathological sign apart from increased bowel sounds. Other investigations showed...