What Is Ileitis?

Ileitis is a condition that refers to inflammation of the ileum, which is the last part of the small intestine. This inflammation can cause a variety of gastrointestinal symptoms, and it may be acute (short-term) or chronic (long-lasting), depending on the underlying cause.

Ileitis is often associated with Crohn’s disease, but it can also result from infections, medications, or other inflammatory disorders.

What Causes Ileitis?

Ileitis can occur for several reasons, including:

• Crohn’s disease – the most common cause, where chronic inflammation affects the digestive tract
• Infections – such as bacterial (e.g., Yersinia, Salmonella, Campylobacter), viral, or parasitic infections
• Nonsteroidal anti-inflammatory drugs (NSAIDs) – which can irritate the gut lining
• Radiation enteritis – inflammation due to previous radiation therapy
• Ischemia – reduced blood flow to the intestines
• Sarcoidosis or tuberculosis – rare causes of chronic inflammation

Each cause may lead to different severity and duration of symptoms.

Who Is at Risk for Ileitis?

Risk factors vary depending on the cause but may include:

• A history of Crohn’s disease or other inflammatory bowel diseases (IBD)
• Recent travel or exposure to contaminated food/water (for infectious ileitis)
• Use of NSAIDs or other medications that irritate the gut
• Undergoing radiation therapy
• Having autoimmune diseases or weakened immunity

What Are the Symptoms of Ileitis?

Symptoms can range from mild to severe and may come and go. Common symptoms include:

• Abdominal pain – usually in the lower right side
• Diarrhea – sometimes with mucus or blood
• Fatigue
• Fever (if infection is present)
• Unintended weight loss
• Bloating or cramping
• Nausea or vomiting

Chronic ileitis, especially due to Crohn’s disease, may also cause malabsorption and nutritional deficiencies.

How Is Ileitis Diagnosed?

Diagnosis typically involves a combination of:

• Medical history and physical exam – to assess symptoms and rule out other conditions
• Blood tests – to check for inflammation, infection, or anemia
• Stool tests – to detect infection or inflammation
• Imaging tests:
  • CT scan or MRI enterography – to visualize inflammation or thickening of the ileum
  • Ultrasound – may be used in children or during pregnancy
• Endoscopy:
  • Colonoscopy with ileoscopy – allows direct visualization and biopsy of the ileum

Biopsies help determine the exact cause of inflammation and rule out Crohn’s disease or infection.

How Is Ileitis Treated?

Treatment depends on the underlying cause:

• For Crohn’s disease:
  • Anti-inflammatory drugs (like corticosteroids)
  • Immunosuppressants or biologics
  • Dietary modifications
  • Surgery (in severe cases)
• For infections:
  • Antibiotics or antiparasitic medications
  • Supportive care (hydration, rest)
• For NSAID-induced ileitis:
  • Discontinuing the offending drug
  • Using gut-protective agents if needed
• For ischemic or radiation-related ileitis:
  • Managing the underlying cause
  • Medications to reduce inflammation

Supportive treatment like hydration, nutritional support, and pain management is often necessary.

Can Diet and Lifestyle Changes Help?

Yes, dietary and lifestyle changes can help manage symptoms and prevent flare-ups:

• Low-residue or low-fiber diets – during flare-ups to reduce irritation
• Avoiding trigger foods – such as spicy, greasy, or high-fat foods
• Staying hydrated – especially if experiencing diarrhea
• Limiting NSAIDs – and using alternatives if needed
• Managing stress – as it can worsen symptoms in chronic cases like Crohn’s disease
• Regular follow-ups – to monitor symptoms and inflammation levels

What Is the Outlook for People with Ileitis?

The outlook depends on the cause:

• Infectious ileitis – often resolves with treatment in a few days to weeks
• Crohn’s disease-related ileitis – is chronic and requires lifelong management but can be well-controlled with proper care
• Drug-induced or radiation-induced ileitis – may improve once the offending cause is removed

Early diagnosis and consistent treatment can significantly improve quality of life and reduce complications.

When Should You See a Doctor?

Seek medical attention if you experience:

• Ongoing abdominal pain
• Persistent diarrhea or blood in the stool
• Fever with gastrointestinal symptoms
• Unexplained weight loss
• Symptoms that don’t improve or worsen with time

Prompt treatment can prevent complications and provide relief.