“A 58 year-old man with a previous history of Crohn's disease presents to his GP with a 3 week history of dizziness when standing up. Whenever he stands he feels unwell and, on two occasions has felt the world “go grey”, experienced muffled hearing and has had to lie flat to alleviate the symptoms. On further questions there has been some difficulty with both micturition and worsening constipation. He has a dry mouth. His Crohn's disease is otherwise well controlled. His cardiovascular examination and neurological examination is normal.”
Discussion
Since, the disease is well controlled cardio and neurological examination is normal, ...