Which statement is NOT an expected finding in acute inflammatory bowel disease?

Which statement is NOT an expected finding in acute inflammatory bowel disease?

• A. Bloody stools containing mucus
• B. Pallor
• C. Anorectal excoriation
• D. Increased serum prealbumin

Answer: (D)

Inflammatory bowel disease in an acute flare causes notable mucosal inflammation with bleeding and mucus, which often leads to pallor from blood loss and anemia. The condition also promotes a catabolic state and impaired synthesis of certain proteins by the liver, so levels of negative acute-phase proteins, like prealbumin, tend to fall rather than rise. Therefore, an increased serum prealbumin would not be expected during an acute flare. The other findings described—bloody stools with mucus, pallor, and anorectal excoriation—are common in active disease due to mucosal damage, anemia, and perianal irritation from frequent stools.