Question: A 37-year-old man from Kenya presented for evaluation of episodic abdominal pain, bloating, and fevers to 39°C. Episodes were self-limited but required hospitalization for pain control. These occurred 4 times over the course of a year, starting with gradual bloating, cramping and then progressing to severe abdominal pain. Episodes lasted 7–10 days and resolved gradually. It is unclear if antibiotics provided any benefit during episodes when treated in Kenya. There was no weight loss during this period.