Cowden syndrome gastrointestinal polyposis

A 56-year-old man presented with chronic watery diarrhea post prandially. His medical history included hypertension, hypothyroidism, gallstone disease status post cholecystectomy, and familial adenomatous polyposis syndrome status post total colectomy in 2020. Family history is notable for type 2 diabetes mellitus in both parents. The mother had a transient ischemic attack, and the father experienced a myocardial infarction at age 70 years. No family history of malignancies was reported. His symptoms persisted despite treatment with cholestyramine.