Symptoms
Common symptoms of ileitis include:
Abdominal pain or cramping, often in the lower right abdomen
Diarrhea (may be bloody in some cases)
Nausea and vomiting
Loss of appetite
Weight loss
Fatigue
Fever (in some cases, especially with infectious ileitis)
Rectal bleeding
Causes
Ileitis can be caused by:
Crohn's disease: This is the most common cause of chronic ileitis. It is an inflammatory bowel disease that can affect any part of the gastrointestinal tract, but frequently involves the ileum.
Infections: Bacterial infections (e.g., Yersinia, *Salmonella*, *Campylobacter*), viral infections, or parasitic infections can cause ileitis.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Prolonged use of NSAIDs can sometimes lead to ileitis.
Ischemia: Reduced blood flow to the ileum can cause inflammation.
Radiation exposure: Radiation therapy to the abdomen can sometimes damage the ileum.
Certain Medications: Some medications can cause inflammation in the ileum.
Medicine Used
The medications used to treat ileitis depend on the underlying cause:
For Crohn's disease:
Anti-inflammatory drugs: Corticosteroids (e.g., prednisone, budesonide), Aminosalicylates (e.g., mesalamine, sulfasalazine)
Immunomodulators: Azathioprine, 6-mercaptopurine, methotrexate
Biologics: TNF-alpha inhibitors (e.g., infliximab, adalimumab), Anti-integrins (e.g., vedolizumab), Anti-IL-12/23 (e.g., ustekinumab)
Small Molecule Medications: Tofacitinib
For Infectious Ileitis:
Antibiotics: Specific antibiotics depend on the type of bacteria causing the infection.
For NSAID-induced Ileitis:
Discontinuation of the NSAID.
Proton pump inhibitors (PPIs) to protect the lining of the small intestine.
Pain Management:
Analgesics to relieve abdominal pain.
Is Communicable
? Whether ileitis is communicable depends on the cause:
Crohn's disease: Not communicable. It's an autoimmune condition.
Infectious ileitis: Can be communicable, depending on the specific infectious agent (e.g., bacteria, virus, parasite). It can spread through contaminated food, water, or contact with infected individuals.
Precautions
Precautions depend on the cause of ileitis:
For Crohn's disease:
No specific precautions to prevent the disease itself.
Managing stress, avoiding trigger foods, and maintaining a healthy lifestyle can help manage symptoms.
For Infectious ileitis:
Practice good hygiene: Wash hands frequently, especially after using the toilet and before preparing food.
Ensure proper food handling and preparation: Cook food thoroughly and avoid consuming contaminated food or water.
Avoid contact with infected individuals: If possible, limit close contact with people who have symptoms of infectious ileitis.
For NSAID-induced ileitis:
Limit or avoid the use of NSAIDs, especially if you have a history of gastrointestinal problems.
Take NSAIDs with food to reduce the risk of gastrointestinal irritation (if use is absolutely necessary).
How long does an outbreak last?
The duration of an ileitis outbreak varies:
Infectious ileitis: Symptoms usually last from a few days to a couple of weeks, depending on the specific pathogen and the individual's immune response.
Crohn's disease: Crohn's disease is a chronic condition with periods of flare-ups (when symptoms worsen) and remission (when symptoms improve or disappear). Flare-ups can last from days to weeks or even months.
NSAID-induced ileitis: Symptoms typically resolve within a few days to weeks after discontinuing the NSAID and starting appropriate treatment.
How is it diagnosed?
Diagnosis of ileitis typically involves:
Medical history and physical examination: The doctor will ask about your symptoms and medical history.
Blood tests: To check for signs of inflammation, infection, and anemia.
Stool tests: To look for infections or blood in the stool.
Imaging studies:
CT scan or MRI of the abdomen and pelvis: To visualize the ileum and look for signs of inflammation or other abnormalities.
X-rays with barium: To examine the small intestine.
Endoscopy:
Colonoscopy with ileoscopy: A colonoscope is inserted into the rectum and advanced into the colon to visualize the large intestine and ileum. Biopsies can be taken for microscopic examination.
Capsule endoscopy: A small camera is swallowed, taking pictures of the small intestine as it passes through.
Biopsy: A small tissue sample taken during endoscopy is examined under a microscope to confirm the diagnosis and determine the cause of ileitis.
Timeline of Symptoms
The timeline of symptoms can vary based on the cause:
Infectious Ileitis:
Incubation Period: A few hours to a few days after exposure to the infectious agent.
Acute Phase: Sudden onset of symptoms such as abdominal pain, diarrhea, nausea, vomiting, and fever, lasting for a few days to a couple of weeks.
Recovery Phase: Gradual improvement of symptoms over a few days to weeks.
Crohn's Disease Ileitis:
Insidious Onset: Symptoms may develop gradually over weeks or months.
Flare-Ups: Periods of increased abdominal pain, diarrhea, fatigue, and other symptoms, lasting for days to weeks or months.
Remission: Periods when symptoms improve or disappear, lasting for weeks, months, or even years.
NSAID-Induced Ileitis:
Gradual Onset: Symptoms may develop over weeks or months of NSAID use.
Chronic Phase: Persistent abdominal pain, diarrhea, and other gastrointestinal symptoms.
Resolution: Symptoms typically improve within days to weeks after stopping the NSAID.
Important Considerations
Early diagnosis and treatment are crucial to prevent complications, especially in cases of Crohn's disease.
Differential diagnosis is important because ileitis can mimic other conditions, such as appendicitis or other gastrointestinal disorders.
Long-term management may be necessary for chronic conditions like Crohn's disease, involving medication, lifestyle changes, and regular monitoring.
Complications of untreated ileitis can include bowel obstruction, abscess formation, fistulas, and malnutrition.
Dietary modifications can help manage symptoms, particularly avoiding trigger foods and maintaining a balanced diet.
Mental health is important, as chronic conditions like Crohn's disease can have a significant impact on psychological well-being.