Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: no known allergies / adverse drug reactions attending: chief complaint: hematochezia major surgical or invasive procedure: flexible sigmoidoscopy history of present illness: 51-year-old male with dm, hld, and gerd who is s/p routine colonoscopy presenting with brbpr. pt states that he had colonoscopy for routine cancer screening on without complications. a polyp was found in the distal sigmoid colon that was removed. he did not notice any brbpr or melena until day of admission when he had two episodes of brbpr. describes frank blood without stool that was painless. he had hemorrhoids in the past but has not had difficulties with constipation recently. he does note that he had been drinking more alcohol lately. he had gone on a business trip from wed to fri where he was drinking about 5 glasses of wine each night. he also has been taking ibuprofen recently for headaches (approximately three 200mg tablets daily). at the ed, initial vitals were 98.4 95 151/101 14 99% ra. he had another episode of frank rectal bleeding (250-300cc) in the ed. gi was called who felt that bleeding was likely from polypectomy site and recommended tap water enemas for flexible sigmoidoscopy. . on arrival to the micu, pt reports feeling well. denies abdominal pain, n/v, chest pain, sob, headache, lightheadedness. past medical history: dm gerd hld social history: lives with wife; they have three children. works as an attorney. quit smoking in . usually minimal alcohol intake but recently drank more during business trip. no recreational drug use family history: great grandfather: gastric cancer no family hx of colon cancer physical exam: on discharge: t 98.1, hr 100s - 110s, 146/86, 17, 99% on ra general: alert, oriented x 3, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities pertinent results: labs upon admission: 11:15pm blood wbc-7.2 rbc-4.27* hgb-13.5* hct-39.3* mcv-92 mch-31.6 mchc-34.3 rdw-12.6 plt ct-217 11:15pm blood neuts-62.2 lymphs-32.0 monos-4.0 eos-1.5 baso-0.3 01:26am blood pt-9.4 ptt-31.4 inr(pt)-0.9 11:15pm blood glucose-228* urean-15 creat-0.9 na-140 k-4.2 cl-103 hco3-24 angap-17 05:24am blood ck(cpk)-65 11:15pm blood ctropnt-<0.01 05:24am blood ck-mb-1 ctropnt-<0.01 05:24am blood calcium-8.7 phos-3.2 mg-2.0 labs upon discharge: 05:24am blood wbc-5.8 rbc-3.79* hgb-11.3* hct-34.9* mcv-92 mch-29.9 mchc-32.5 rdw-12.6 plt ct-187 05:24am blood glucose-187* urean-14 creat-0.8 na-140 k-4.1 cl-105 hco3-26 angap-13 flex sig: : at 15 cm a 2cm clot was noted over an ulcerated polypectomy site. the area was treated with clips and gold probe cautery with successful hemostasis. spot ink was also applied to the area for tattooing (endoclip, thermal therapy, injection) otherwise normal sigmoidoscopy to distal sigmoid colon recommendations: the polypectomy site was the likely source of bleeding. hemostasis was achieved. avoid nsaids for the next 14 days. follow up with dr. . brief hospital course: 51 year old man with type 2 diabetes mellitus, hyperlipidemia, and gerd who presented with hematochezia after recent polypectomy (completed on ). his hematocrit trended from 39 -> 34 -> 29. he was admitted to the micu, but remained hemodynamically stable throughout his hospital course with exception of sinus tachycardia with ambulation. he was given intravenous hydration. pathology from the polypectomy revealed an adenoma with high grade dysplasia. repeat flexible sigmoidoscopy on was completed which showed clot at site of prior polypectomy. further excision of the base of the prior polyp was completed with cautery and clips. the area was tatooed. his diet was advanced and he was discharged with follow up with his pcp and his . follow up hematocrit on after the sigmoidoscopy was 29. it was recommended that he stay one more night in the hospital to ensure that his hematocrit was stable and bleeding has stopped, but the patient elected to leave against medical advice. patient was informed of possible risks of leaving against medical advice including but not limited to hemorrhage, hypotension, shock, mi, and death. he has persistent headaches after drinking alcohol. recommended avoiding alcohol and nsaids for 2 weeks to prevent further bleeding. patient will follow up with his pcp regarding work up for his chronic headaches. his oral diabetes mellitus medications were held and he was controlled on insulin during hospitalization. home medications restarted on discharge. he was full code for this admission. medications on admission: glipizide - 5 mg tablet - one tablet(s) by mouth daily metformin - 500 mg tablet - one tablet(s) by mouth in the am , one in the evening and two at bedtime pantoprazole - 40 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day simvastatin - 20 mg tablet - 1 tablet(s) by mouth once a day discharge medications: 1. glipizide 5 mg tablet sig: one (1) tablet po once a day. 2. metformin 500 mg tablet sig: one (1) tablet po 1 tab in am, 1 tab in pm, 2 tabs at bedtime. 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 5. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 6. tramadol 50 mg tablet sig: one (1) tablet po once a day as needed for headache: do not drive or operate heavy machinery while taking this medication. disp:*10 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: post-polypectomy bleed colon polyp with high grade dysplasia secondary: diabetes mellitus hyperlipidemia gerd discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you came to the hospital because of bloody stool, which was a result of your recent polypectomy. the pathology report from the removed polyp returned as "adenoma with high grade dysplasia." this pathology infers a high risk of progression to colon cancer, therefore our gastroenterologists preformed a flexible sigmoidoscopy to re-examine the polypectomy site. during the procedure they removed as much as possible from the base of the polyp and also marked the area with dye for repeat procedures. you will need to follow up closely with your dr. in the next coming weeks. please avoid ibuprofen and all other nsaids due to risk of further bleeding. please take tylenol as needed for headache, if the tylenol does not help, you can take tramadol. please avoid alcohol as this is worsening your headaches. your hematocrit (marker of anemia) dropped from 39 to 29 during your hospitalization. we recommended you stay one night more in order to ensure that the bleeding does not continue. we would like to monitor you further and check additional blood counts. however, you decided to leave against medical advice. if you have any further bleeding, lightheadedness, or abdominal pain, please call your primary care doctor immediately or come back to the emergency department. followup instructions: dr. will schedule follow up with you, but if you do not hear from him by the end of this week, please call to confirm a follow up appointment. dr. at 12pm location: healthcare - group address: , , , phone: md procedure: control of hemorrhage, not otherwise specified rigid proctosigmoidoscopy diagnoses: esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of tobacco use other and unspecified hyperlipidemia hemorrhage complicating a procedure other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation benign neoplasm of colon 

Answer: The patient is high likely exposed to