Which statement about the evaluation of this patient includes the procedures mentioned?

• A. Flexible sigmoidoscopy and barium enema
• B. Colonoscopy and CT scan
• C. Endoscopy and ultrasound
• D. MRI and PET scan

Answer: (A)

When evaluating suspected inflammatory bowel disease, you want both a direct look at the colon’s mucosa and a broader view of how far the disease extends. Flexible sigmoidoscopy lets you inspect the distal colon (rectum through sigmoid) and take biopsies to determine inflammation type and obtain a tissue diagnosis. A barium enema provides a radiographic map of the colon, showing its contour, caliber, and mucosal pattern over a longer stretch, which helps determine whether inflammation is limited to the left side or extends proximally and whether the pattern is continuous (as in ulcerative colitis) or patchy (as in Crohn’s).

Using these two together gives complementary information: biopsy-confirmed mucosal findings from the distal colon plus a radiographic view of disease distribution. The other options involve modalities that either focus on areas not primarily involved in typical distal disease or rely on newer imaging that isn’t as informative for mapping colitis in this context.