Pershing Anwar Colon Epigastric discomfort 1 month Relieved by hunger Not awakening her from sleep Potato aggravated Chronic intermittent constipation (hard stool) 8 years No diarrhea BPR once little blood 1 month ago with constipation Anal itching 8 years No melena No weight change No heartburn, regurgitation rarely, no dysphasia, normal appetite. No fever or rigor Nausea, no vomiting 24-Jan-2021 FOB: +ve 18-Jan-2021 Glucose: 104 (normal) Creatinine: 0.7 (normal) TSH: 3.45 (normal) CBC: Normal 265 cholesterol Rosuvastatin? NKDA PMH: -ve PSH: -ve Drug FH: -ve Not menstruating for 2 years Pallor face, coarse skin, eye brow, tremor (benign familial) Fullness in epicanthic No LAP, no TM, no pitting Soft, no tenderness. TAUS, Stool Ag HP, ALT, ALP +- OGD and colonoscopy