Ileitis

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.