What is terminal ileum inflammation?

Terminal ileum inflammation (also known as terminal ileitis or regional enteritis) is an intestinal disease. It can lead to severe abdominal pain, severe diarrhea, weight loss, and fever. The terminal ileum is the last part of the small intestine. Infection with the bacterium helicobacter pylori can lead to terminal ileum inflammation and disease.


ileum
Ileum


How common is it?

The exact number of people with this condition in the United States is not known. Researchers do know that about 20% of the world population carries H. pylori in their stomachs, so 1 out of 5 people will be infected during their lifetime. Because it is very common, terminal ileum inflammation is a leading cause of intestinal disease worldwide.


What causes terminal ileitis?

H. pylori infection is the main cause of disease in people with terminal ileitis. Most people who get this infection also have other problems, such as low levels of iron or vitamin B12, or anemia (a decrease in red blood cells). The bacterium H. pylori infect the stomach and then spreads to the digestive tract, including the small intestine. It can invade tissue deep within the lining of the stomach and then move up between two very important layers that line the inside surface of parts of your body called epithelial cells. These layers are called mucous membranes. As it moves through these tissues, H. pylori cause inflammation (redness and swelling)


What are the symptoms?

Symptoms of terminal ileum inflammation include abdominal pain, loss of appetite, diarrhea (watery and bloody), fever, vomiting, weight loss, and weakness. The main symptom is usually severe abdominal pain that occurs 1 to 3 weeks after the H. pylori infection has occurred in the stomach. This can interfere with daily activities such as walking, moving side-to-side while lying down (such as during sleep), and/or standing up from a seated position. Diarrhea may occur with or without blood in it. People with terminal ileum inflammation usually have a fever and weight loss.


What tests diagnose it?

A health care provider diagnoses terminal ileum inflammation by examining a patient's medical history, symptoms present, and a physical exam of the abdomen. No blood test is available to diagnose terminal ileum inflammation; however, a stool sample may be tested for evidence of H. pylori infection or its antibodies. 

Other lab studies that may be done include: 

C-reactive protein (CRP) - CRP can indicate an active inflammatory bowel disease as well as other diseases such as appendicitis, diverticulitis, and cancer. 

Stool cultures - These are used to detect parasitic infections such as giardia lamblia. Serology test for antibody against H. pylori. 

Biopsy of the terminal ileum - A tissue sample is removed and tested for signs of inflammation, infection, or other diseases such as Crohn's disease. 

Colonoscopy - This test allows a health care provider to view and take pictures of the colon and rectum using a small flexible scope inserted into the anus. During this exam, polyps, growths that can be either benign or cancerous, can be removed before they become large enough to cause problems.

Inflammation may also be seen with other medical conditions such as gastric ulcers, intestinal infections (such as giardiasis), inflammatory bowel disease (Crohn's disease), stomach cancers (adenocarcinomas), medications used in chemotherapy, parasitic infections, and autoimmune diseases.


How is it treated?

Treatment for terminal ileum inflammation depends on how severe the condition is. If there are no symptoms or complications from the terminal ileum inflammation, then treatment may include: 

fasting - Only clear liquids are taken by mouth until symptoms go away. Foods high in fiber are not allowed because they can irritate the digestive tract. 

Antibiotics medications - These drugs are used to kill H. pylori infection so that it cannot further inflame the intestine. Medicines to control diarrhea or stomach acid may also be given along with antibiotics if these problems occur with the illness. Sometimes a combination of medications including bismuth, tetracycline, metronidazole, and omeprazole is used to treat the H. pylori infection. 

Surgery - If Crohn's disease or cancer has developed in the terminal ileum, then surgery is required to remove the diseased part of the intestine.

Health care providers will monitor people closely who have terminal ileum inflammation for any worsening of symptoms during treatment. Symptoms may return once treatment is stopped unless the underlying cause of terminal ileum inflammation (such as Crohn's disease) can be successfully treated so that it does not come back again causing further damage to the intestinal tract. 

During flare-ups, medications are also used to control these symptoms along with lowering stress levels through relaxation techniques such as various types of counseling, hypnosis, and deep breathing.


What is the prognosis?

The prognosis for people with terminal ileum inflammation depends on whether the underlying cause of the disease is some other illness such as Crohn's disease or H. pylori infection. With early diagnosis and treatment, many people respond well to therapy and recover fully from their illness. In more severe cases, partial or total removal of a diseased part of the intestinal tract may improve health status.

 However, people who have been diagnosed with an autoimmune disease such as rheumatoid arthritis, lupus, scleroderma, or vasculitis are at risk for developing complications from terminal ileum inflammation due to irreversible damage to tissues in organs throughout the body. Health care providers closely monitor these people for flare-ups that may require treatment to prevent any further damage to other organs.

The risk of developing terminal ileum inflammation increases with age. The disease is diagnosed most often in people between the ages of 40 and 70 years, but it can also affect children as young as 5 years old. It affects both men and women equally. Terminal ileum inflammation usually occurs without a clear cause or prior warning signs. 

Crohn's disease, ulcerative colitis, celiac disease, irritable bowel syndrome, appendicitis, diverticulitis, gallstones, giardiasis (a parasitic infection), and stomach cancer are some other illnesses that can lead to this condition by producing long-term complications within the digestive tract. The condition itself is a chronic illness that can be life-threatening for some people if not diagnosed or treated promptly and properly.

Terminal ileum inflammation is a serious inflammatory bowel disease that affects thousands of people worldwide. 


Where is terminal ileum pain?

The pain of terminal ileum inflammation is usually felt in the lower right area of the abdomen, which includes the appendix, spleen, and part of the ascending colon. The disease may also spread to other parts of the digestive tract including the jejunum (middle section of the small intestine), cecum, iliac crest (border) on each side of the body that goes down into the pelvis where two long bones converge, or into many other organs throughout your body. 

The cause for terminal ileum pain is unknown but it can include diseases such as Crohn's disease, cancerous tumors within these areas, tuberculosis infection, H. pylori infection, scleroderma, or vasculitis. Terminal ileum inflammation can also be caused by autoimmune diseases such as rheumatoid arthritis, lupus, and scleroderma.


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Is terminal ileitis serious?

Terminal ileum inflammation is serious. If it is not diagnosed or treated properly, the condition can progressively worsen over time by changing the normal intestinal function or damaging other tissues in various parts of your body including the kidney, liver, pancreas, and spleen.

Symptoms become more severe when there is chronic inflammation without an underlying cause that can be successfully treated. This disease can also have complications that may require emergency medical attention to prevent life-threatening conditions from developing. 

The health care provider will closely monitor people who have terminal ileum inflammation for any worsening of symptoms during treatment. Symptoms may return once treatment is stopped unless the underlying cause of terminal ileum inflammation (such as Crohn's disease) can be successfully treated so that it does not recur.

Terminal ileum inflammation is a chronic illness that affects thousands of people worldwide. It most often occurs in people between the ages of 40 and 70 years, but can also affect children as young as 5 years old. Although it is more common in men than women, there are no differences between sexes when it comes to having terminal ileum pain. 

The cause for this condition is unknown but health care providers believe that it may be due to an infectious agent or autoimmune diseases such as rheumatoid arthritis, lupus, or scleroderma. This condition can produce complications if not diagnosed properly and treated early on so don't wait! If you have symptoms lasting longer than 2 weeks, see your health care provider immediately.


What does terminal ileum mean?

The terminal ileum is the last section of the small intestine before waste matter moves into the large intestine. People with Crohn's disease often develop inflammation in this part of their digestive tract which leads to pain, fever, and diarrhea.


Can ileitis be cured?

Like Crohn's disease, there is no cure for terminal ileum inflammation. Treatment focuses on managing symptoms and preventing organ damage over time. This may include medications to treat the illness itself or manage specific conditions that may be causing pain in this area of the body. As with most chronic illnesses, it is also very important to maintain a healthy diet, exercise regularly, and get enough rest so that your body can heal properly.

There are several different medications available depending on what kind of condition you have. The treatment will vary depending on each individual case but is designed to reduce the risk of complications while improving quality of life. 

Today there are many safe treatments options available to help manage pain, control inflammation and support overall health. Some people may need medication and surgery to help improve symptoms while others may be able to manage their symptoms without surgery.


Is ileitis always Crohn's?

No, it's not always Crohn's. There are several other conditions that can cause this type of inflammation (and Crohn's itself).

Terminal ileum pain is most common in people with the following conditions:

Crohn's disease – a chronic inflammatory condition of the digestive tract and/or intestines. Symptoms include severe abdominal cramps, diarrhea, and rectal bleeding. It usually affects young adults and children but has been known to affect all age groups.

Colitis - an inflammation or irritation of the large intestine (colon) that causes symptoms such as abdominal cramping, often bloody diarrhea, gas, fatigue, and weight loss. It is commonly associated with ulcerative colitis but may also be caused by Crohn's disease, irritable bowel syndrome, and other conditions.

Scleroderma - a rare autoimmune disorder that causes the body to attack its connective tissues leading to scarring or hardening of the skin on hands, feet, or other areas of the body but is also associated with internal organs such as the uterus, digestive system, blood vessels, and joints.

Lupus erythematosus - an autoimmune condition where the immune system attacks healthy tissues in various parts of the body including skin, kidneys, heart, or lungs. It is commonly seen with terminal ileum pain but may also present itself as arthritis, muscle aches, and fatigue.

Psoriasis – a type of chronic inflammatory skin disease that produces red scaly patches on the skin that sometimes cut into deep, painful cracks.

Vitamin B12 deficiency - an important vitamin that helps maintain healthy nerve cells including those in your gastrointestinal tract. Since this vitamin is found primarily in meat products, people who follow a vegan or vegetarian diet are more likely to develop deficiencies of Vitamin B12 which can contribute to developing terminal ileum pain.