Ileitis: Inflammatory Bowel Disease Explained

Ileitis, also known as Crohn's disease, is a type of inflammatory bowel disease (IBD) that primarily affects the ileum, which is the last part of the small intestine. This condition is characterized by inflammation, which can occur in any part of the digestive tract from the mouth to the anus. However, it most commonly affects the ileum.

The inflammation caused by ileitis can penetrate deep into the affected tissue, causing pain and potentially leading to serious complications. This article aims to provide a comprehensive understanding of this condition, its causes, symptoms, diagnosis, and treatment options.

Understanding Ileitis

Ileitis is a chronic condition, meaning it persists for a long time or constantly comes and goes. It can occur at any age, but it is most likely to begin in people in their late teens and early 20s. The inflammation in the digestive tract can lead to both immediate problems, like ulcers and abscesses, and long-term complications, such as bowel obstruction and malnutrition.

The exact cause of ileitis is unknown, but it is believed to be the result of an abnormal immune response. This means that the body's immune system mistakenly attacks the healthy cells in the digestive tract, causing inflammation.

Types of Ileitis

There are several types of ileitis, each with its own unique set of symptoms and complications. The most common type is terminal ileitis, which affects only the end of the small intestine. Another type is backwash ileitis, which is typically seen in people with ulcerative colitis, another form of IBD.

Regional ileitis, also known as Crohn's disease, affects any part of the digestive tract but most commonly the ileum. Diffuse ileitis affects the entire small intestine, while segmental ileitis affects different parts of the small intestine.

Causes and Risk Factors

While the exact cause of ileitis is unknown, several factors may increase your risk of developing the disease. These include age, as ileitis is more common in people under 30; family history, as you're more likely to develop the disease if a close relative has it; smoking, which is the most controllable risk factor; and nonsteroidal anti-inflammatory medications, which can increase the risk of developing the disease or worsening its symptoms.

Other potential risk factors include ethnicity, as Caucasians and people of Eastern European (Ashkenazi) Jewish descent are at higher risk, and location, as people living in urban areas or northern climates are more likely to develop ileitis.

Symptoms of Ileitis

The symptoms of ileitis can vary greatly from person to person and depend on the location and severity of the inflammation. Some people with mild ileitis may have no symptoms, while others with severe ileitis may have frequent, debilitating symptoms.

Common symptoms of ileitis include abdominal pain and cramping, diarrhea, weight loss, and reduced appetite. Other symptoms may include fever, fatigue, night sweats, and in some cases, symptoms outside the digestive tract such as joint pain, eye inflammation, skin disorders, and liver or bile duct diseases.

Complications of Ileitis

Ileitis can lead to several complications, some of which can be serious. These include bowel obstruction, where inflammation or scar tissue can block the passage of food through the digestive tract; ulcers, which can occur anywhere in the digestive tract, including the mouth and anus; fistulas, which are abnormal connections between different parts of the intestine or between the intestine and other organs; and malnutrition, due to the body's inability to absorb nutrients properly.

Other potential complications include anemia, due to loss of blood from inflamed intestines; colon cancer, as people with ileitis have an increased risk of colon cancer; and other health problems, such as osteoporosis, gallbladder or liver disease, and inflammation in other areas of the body, such as the joints, eyes, and skin.

Diagnosis of Ileitis

Diagnosing ileitis can be challenging, as its symptoms are similar to those of other digestive disorders. Your doctor will likely use a combination of medical history, physical examination, and tests to diagnose the condition. These tests may include blood tests to check for anemia or signs of infection, stool tests to check for blood in the stool, and imaging tests, such as a colonoscopy or CT scan, to visualize the intestines.

During a colonoscopy, your doctor may take a small sample of tissue (biopsy) for analysis, which can help confirm the diagnosis. In some cases, your doctor may also perform a capsule endoscopy, where you swallow a capsule that has a tiny camera inside it. The camera takes pictures of your small intestine, which are transmitted to a recorder you wear on your belt.

Differential Diagnosis

It's important to distinguish ileitis from other conditions that can cause similar symptoms. These include other types of IBD, such as ulcerative colitis; infectious diseases, such as bacterial or parasitic infections; and non-IBD gastrointestinal disorders, such as irritable bowel syndrome (IBS).

Your doctor will consider these and other possibilities based on your medical history, symptoms, physical examination, and test results. In some cases, it may take time and a process of elimination to reach a definitive diagnosis.

Treatment of Ileitis

There is currently no cure for ileitis, but treatments can reduce the inflammation that triggers your symptoms. The goal of treatment is to reduce symptoms, achieve long-term remission, and prevent complications. Treatment options depend on the severity of your symptoms and may include medications, dietary changes, and in some cases, surgery.

Medications for ileitis may include anti-inflammatory drugs, immune system suppressors, antibiotics, pain relievers, and iron supplements. Dietary changes may include a low-residue diet, which can help reduce the frequency of bowel movements, and nutritional supplements, to ensure you're getting the necessary nutrients.

Surgical Treatment

In some cases, if diet and lifestyle changes, drug therapy, or other treatments don't relieve your ileitis symptoms, your doctor may recommend surgery. Surgery for ileitis is not a cure and is generally considered only when other treatments have failed or if you have complications such as a fistula, abscess, or bowel obstruction.

The most common surgery is resection, where the surgeon removes a damaged portion of your digestive tract and then reconnects the healthy sections. Another type of surgery is strictureplasty, which widens a narrowed segment of the intestine without removing it.

Living with Ileitis

Living with ileitis can be challenging, but with the right treatment and support, most people with the disease can lead active and fulfilling lives. It's important to work closely with your healthcare team to manage your symptoms and monitor for potential complications. Regular check-ups, a healthy diet, regular exercise, and stress management can all help you manage your condition and improve your quality of life.

Support from family, friends, and support groups can also be invaluable. Don't hesitate to ask for help when you need it, and consider joining a support group, where you can connect with others who are facing the same challenges.