Case Lab · Type B · Transfer

F59

"I'll just call it unspecified for now"

A referral letter states: "Patient reports two years of daily over-the-counter laxative use well beyond medical indication, maintained by a firm belief that it is necessary for internal 'cleansing.' No binge eating, no body-image concern, no tolerance or withdrawal symptoms on stopping. Pharmacist has repeatedly advised discontinuation without success." A trainee, pressed for time, writes up the referral as "F59 — unspecified, will need more history," without re-reading the letter closely enough to notice the detail needed to classify further is already there.