Authors S. VAN LANGENDONCK (1), G. VAN PARYS (2), M. COOL (3), G. LAMBRECHT (3), G. DEBOEVER (3) / [1] AZ Damiaan, Oostende, Belgium, Gastro-enterologie, [2] AZ Damiaan, Oostende, Belgium, anatome pathologie, [3] AZ Damiaan, Oostende, Belgium, gastro-enterologie A 63 year old female patient consulted our outpatient clinic for a second opinion concerning therapy refractory ulcerative colitis. This was diagnosed last year based on endoscopy and pathology findings and she has been treated since then with 5-ASA suppositories and beclomathason tablets, without any improvement of the symptoms. Her past medical history included a hysterectomy, a cystopexy and a bipolar disorder. Her current complaints were rectal tenesmus, intermittent anal blood loss and fecal incontinence. The clinical abdominal examination was normal. On digital rectal examination the resting tone of the anal sphincter and the voluntary contraction were clearly reduced. The laboratory tests were normal, excluding a slightly elevated C-reactive protein at 7.2 mg/L (reference range
