What Is Ileocolitis?

Ileocolitis is inflammation of the end of the small intestine (ileum) and a portion of the large intestine (colon). It is the most common type of Crohn’s disease, which is part of a group of conditions known as inflammatory bowel disease (IBD).

Ileocolitis is a chronic disease, meaning it persists over a long period of time. There currently is no cure for ileocolitis or Crohn’s disease. It most often comes on gradually and worsens over time. 

Other Types of Crohn’s Disease

Other types of Crohn's disease include:

• Ileitis: Inflammation of the last section of the small intestine (ileum) only
• Gastroduodenal Crohn’s: Inflammation of the stomach and the beginning of the small intestine (duodenum)
• Jejunoileitis: Inflammation of the middle section of the small intestine (jejunum)
• Crohn's (granulomatous) colitis: Inflammation of the large intestine (colon) only

Ileocolitis Symptoms

Symptoms of ileocolitis may vary over time. You might experience symptoms daily, or you could have weeks or years with no symptoms at all, called remission. 

Common symptoms of ileocolitis include: 

• Diarrhea
• Cramping or pain in the middle or lower abdomen
• Unintentional weight loss

Causes

The exact cause of ileocolitis and other types of Crohn’s disease is unknown. However, health professionals believe there are some things that may play a role. These include:

• Autoimmune reaction: When your immune system mistakenly attacks healthy cells in your body, it may cause inflammation and lead to the development of Crohn’s disease.
• Family history: ​​If you have an immediate family member (parent or sibling) with Crohn’s disease, you may be more likely to develop symptoms. 
• Smoking: Smoking may double your risk of developing Crohn’s disease.
• Certain medications: Taking certain medications may slightly increase your risk of developing Crohn’s disease. These include some antibiotics, birth control pills, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
• Diet: A diet high in fat may also slightly increase your risk of Crohn’s disease.
  

Diagnosis

To get an idea of your overall health, your doctor will most likely start by asking about your general health, medical history, and your symptoms. They may also want to perform a physical exam, blood tests, or ask for a stool sample. This can help rule out other possible causes for your symptoms, such as bacterial or viral infections.

If your doctor suspects any form of Crohn’s disease, they will also likely want to examine the inside of your gastrointestinal (GI) tract by doing an intestinal endoscopy. This involves inserting a tube with a camera on it through the anus or mouth.

Other tests your doctor might refer you for include getting X-rays and other images of your GI tract by performing an upper GI series or a computed tomography (CT) scan.

Treatment

Treatments for ileocolitis include medications, diet changes, bowel rest, and surgery. Treatment may look different from one person to another with ileocolitis. 

The main goals of treatment are to decrease the inflammation in your intestines, reduce symptoms, prevent flare-ups, and keep you in remission.

Medications

The most common medications for ileocolitis and other forms of Crohn’s disease are anti-inflammatory drugs, such as oral 5-aminosalicylates (5-ASAs) and corticosteroids. These work to reduce the inflammation in your GI tract.

Doctors often prescribe 5-aminosalicylates for people who are newly diagnosed with ileocolitis and whose symptoms are mild.

Corticosteroids are another common medication for ileocolitis. They are generally used only as a short-term treatment because there are many possible side effects, such as nausea, heartburn, weight gain, and increased risk of osteoporosis, diabetes, and high blood pressure.

Other common medications for ileocolitis are immunomodulators, or immune system suppressors. These help reduce inflammation in your digestive tract by decreasing the activity of your immune system. They can take several weeks to three months to start working.

Immunomodulators can have serious side effects, so your doctor might prescribe them only if you have severe ileocolitis and aren’t responding to other treatments.

Biologic therapies, such as infliximab, are another option if you do not respond well to other treatments. These neutralize proteins made by the immune system to help decrease inflammation in your GI tract. Side effects of biologic therapies include a toxic reaction to the medicine and a higher chance of developing infections.

Diet Changes

While ileocolitis may not be the result of your diet, changing what you eat may help reduce symptoms. Keeping a food diary can be helpful in identifying specific foods to avoid during a flare-up.

In general, your doctor or dietitian may recommend that you make changes to your diet, especially during times of flare-ups, such as:

• Avoid carbonated beverages.
• Reduce high-fiber foods, such as popcorn, vegetable skins, nuts, and seeds.
• Drink plenty of water throughout the day.
• Eat smaller meals.
• Avoid spicy foods.
• Limit dairy products if you are lactose intolerant.
  

Overall, during times of remission, your diet can remain flexible and should include a variety of foods from all food groups in order to maintain good nutrition.

If you are having difficulty identifying any trigger foods, your diet has become very limited, or you are losing weight without trying to, meet with a registered dietitian.

Bowel Rest

If you are experiencing severe symptoms without relief from other treatments, your doctor may prescribe bowel rest. This involves drinking only certain liquids or not eating or drinking anything for a few days. 

Bowel rest may be done at home but is sometimes done in the hospital while you receive nutrition through a feeding tube or an IV. In most cases, your symptoms will decrease as your digestive tract heals with the bowel rest.

Surgery

While surgery does not cure ileocolitis or Crohn's disease, it can preserve portions of your intestines while giving you a better quality of life.

A 2012 study found that 60% of people with Crohn's disease had surgery at some time during 20 years with the condition. However, a 2021 study found the rate of surgery has been declining significantly.

If you are not responding to medications or diet changes and your ileocolitis symptoms are severely affecting your quality of life, you may be a candidate for surgery.

You might also require surgery if you develop any complications, such as a fistula (abnormal connection between two body cavities), fissure, intestinal obstruction, or life-threatening bleeding.

There are different types of surgery used to treat Crohn’s disease. However, it often involves removal of the diseased segment of the bowel (resection) and then joining the two ends of healthy bowel together (anastomosis). 

While surgery can put you in remission for many years, Crohn’s disease may return later in life.

Prognosis

There is no known cure for ileocolitis or Crohn’s disease. It is a chronic condition, although symptoms can vary over time and you may be in remission for several years at a time.

Sometimes you might have flare-ups that cause more severe symptoms and greatly impact your quality of life. However, with proper treatment, most people are able to lead productive lives.

Coping

Symptoms of ileocolitis can affect your quality of life, as well as your relationships and work life. However, talking to and seeking support from family, friends, therapists, and other healthcare professionals can help. 

Other coping strategies include becoming educated on your disease, problem-solving, and positive reevaluation of upsetting or stressful experiences. Additionally, you can improve your quality of life and reduce symptoms and complications by sticking to your treatment plan, avoiding possible triggers, and getting regular healthcare checkups.

Summary

Ileocolitis is the most common type of Crohn's disease. It displays chronic inflammation of the end of the small intestine and a portion of the large intestine. Symptoms often include diarrhea, abdominal pain or cramping, and weight loss.

There is no cure for the condition, which usually comes on gradually and worsens over time. Medications and surgery may be used to treat symptoms and complications.

A Word From Verywell

Living with a complex, chronic condition like ileocolitis can be very frustrating and challenging at times. Take charge of your disease by learning about available resources and reviewing the risks and benefits of all treatment options with your healthcare team. This can help you make informed decisions about your care and treatment plan.

By being a lifelong learner and working in partnership with your family, friends, and healthcare team, you can have a great quality of life.