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Terminal Ileitis - Treatment, Symptoms, Causes, Pictures


What is Terminal Ileitis?

Terminal ileitis is also referred as Crohn’s disease that affects the terminal ileum or the rear part of the small intestine. It is a disease that is closely related to ulcerative colitis and both are referred to as inflammatory bowel disease.

Terminal ileitis is a common disease that equally affects male and female with the peak onset between the ages of 15 and 35 years. The disease also tends to run in the family wherein two or more members of the family can suffer from terminal ileitis.

The terminal ileum is the end and most distal part of the small intestine that leads to the cecum which adjoins the small intestine to the large intestine. The terminal ileum is responsible for absorbing the materials that are not digested by the jejunum or the middle part of the small intestine. It also facilitates the absorption of Vitamin B12 including the bile salts produced by the liver. It is a part of the digestive system that is potential for negative effects of medical conditions known as Crohn’s disease.


The onset of symptoms of terminal ileitis may come in gradually or may occur suddenly. The range and severity of the symptoms varies and depends on the extent of the inflammation.

Abdominal pain is the most common symptom of terminal ileitis which is often perceived in the lower right area of the abdomen. The abdominal pain can be so severe which may have a debilitating effect on the patient. Cramping is also exhibited and is due to the inflammation and ulceration affecting the walls of a part of the bowel. The abdominal pain and cramping can go from mild to moderate resulting to intestinal discomfort or the pain can be so severe and may be accompanied by nausea and vomiting.

Diarrhea is also expected and is often the result of large absorption of water and salt that cannot be absorbed by the colon. Intestinal cramping is also another factor that can result to diarrhea.

Diminished appetite and weight loss is another symptom of the disease which resulted from an inflammatory reaction in the wall of the bowel including the abdominal pain and cramping affecting the appetite and the ability to absorb the food and its nutrients.

Blood in the stool is also noted at the onset of terminal ileitis. It is the result of the aggravation of the food moving through the digestive tract passing to the inflamed tissue that causes the bleeding. The stool may be noticed mixed with a bright red or darker color of blood.

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Other less common symptoms of terminal ileitis include the following:

  • Pain in the joint and the spine
  • Abdominal distention
  • Fatigue
  • Onset of fever
  • Skin problems
  • Liver or bile duct inflammation
  • Mouth sores


The exact cause of terminal ileitis remains unidentified and was previously suspected to be associated with diet and stress. The suspicion however was not clearly confirmed but the factors were instead considered to initiate the onset of the disease.

Hereditary factor is among the factors considered in the cause of the disease. The characteristic of the disease to be running in the family raised the suspicion of terminal ileitis linked with the genes in the family.

Immune system is another factor believed to play a role in the incidence of terminal ileitis. It is believed that the immune system is also attacking the digestive tract while it is warding off microorganisms from viral or bacterial infection.


Terminal ileitis has no known cure just like the other inflammatory bowel disease. The aim of treatment is to relieve the symptoms that resulted from the inflammation.

Treatment of terminal ileitis includes the following:

Anti-inflammatory agents such as corticosteroid, sulfasalazine and mesalamine are the first line of treatment for terminal ileitis to reduce the inflammation causing the symptoms.

Immunosuppressant drugs such as methotrexate, cyclosporine, infliximab and azathioprine are considered to reduce the inflammation by suppressing the immune response of the body.

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