November 24 2020 This is an online E log book to discuss our patients deidentified health data shared after taking his/her/guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This E log book also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. CASE PRESENTATION: A 70 year old women who is a housewife came with chief complaints of loose stools with blood since 6 days . Patient was apparently asymptotic 1 year back then she developed loose stools associated with blood ( small volume , with increased frequency of stools ) 3 times in a day for last 3 days ( 4 times in a week, feeling of incomplete defecation present and intermittent constipation present,loose stools associated with smell and not associated with pain a