Ileitis: When It is Not Crohn’s Disease

Abstract

Ileitis, or inflammation of the ileum, is often caused by Crohn’s disease. However, ileitis may be caused by a wide variety of other diseases. These include infectious diseases, spondyloarthropathies, vasculitides, ischemia, neoplasms, medication-induced, eosinophilic enteritis, and others. The clinical presentation of ileitis may vary from an acute and self-limited form of right lower quadrant pain and/or diarrhea, as in the majority of cases of bacterial ileitis, but some conditions (ie, vasculitis or Mycobacterium tuberculosis) follow a chronic and debilitating course complicated by obstructive symptoms, hemorrhage, and/or extraintestinal manifestations. Ileitis associated with spondylarthropathy or nonsteroidal anti-inflammatory drugs is typically subclinical and often escapes detection unless further testing is warranted by symptoms. In a minority of patients with long-standing Crohn’s ileitis, the recrudescence of symptoms may represent a neoplasm involving the ileum. Distinguishing between the various forms of ileitis remains a test of clinical acumen. The diagnosis of the specific etiology is suggested by a detailed history and physical examination, laboratory testing, and ileocolonoscopy and/or radiologic data.

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The content of this publication is the sole responsibility of the authors and does not necessarily reflect the views or policies of the National Institutes of Health or the Department of Health and Human Services, the Department of Defense, or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the US Government. This work is original and has not been published elsewhere.

Dr. Crum-Cianflone has received research funding from the National Institute of Allergy and Infectious Diseases. No other potential conflict of interest relevant to this article was reported.

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Correspondence to Nancy F. Crum-Cianflone.

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DiLauro, S., Crum-Cianflone, N.F. Ileitis: When It is Not Crohn’s Disease. Curr Gastroenterol Rep 12, 249–258 (2010). https://doi.org/10.1007/s11894-010-0112-5

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Keywords

  • Ileitis
  • Crohn’s disease
  • Infectious ileitis
  • Yersinia
  • Salmonella
  • Clostridium difficile
  • Typhlitis
  • Mycobacterium tuberculosis
  • Mycobacterium avium
  • Actinomycosis
  • Anisakiasis
  • Cytomegalovirus
  • Histoplasmosis
  • Spondyloarthropathies
  • Vasculitis
  • Ischemia
  • Neoplasms
  • Drug-induced
  • NSAID enteropathy
  • Eosinophilic enteritis
  • Sarcoidosis
  • Amyloidosis
  • Backwash ileitis