Background: Sarcoidosis is a chronic multisystem disease of unknown etiology characterized by non-caseating granulomas, which rarely involves the colon. We present a case of colonic sarcoid presenting
as worsening abdominal pain and constipation.Case Report: A 59-year-old white female with past medical history of latent pulmonary sarcoidosis presents with worsening constipation over several years. Her physical examination was normal except for diffuse mild abdominal tenderness without masses, hepatosplenomegaly, or evidence of ascites. The rest of the clinical examination and laboratory tests were within normal limits. The colonoscopy appeared endoscopically normal with the exception of two nodules in the sigmoid colon at approximately 20 cm from the anal verge. Microscopic evaluation of biopsies revealed non-necrotizing granulomas consistent with sarcoidosis. A diagnosis of sarcoidosis with colonic involvement prompted a trial of Prednisone (40mg daily) with resolution of her abdominal pain and constipation.Conclusions: Colonic sarcoid should be considered in patients with progressive unremitting constipation and pain in the setting of known extraintestinal sarcoidosis.

Keywords: angiotensin converting enzyme (ACE), Constipation, sarcoidosis, Colon