By Dr. Loretta Lanphier, ND, CN, HHP, CH

Sitting down to a delicious meal is something that many of us take for granted. We eat and enjoy the experience, and don’t give it much more thought. However, when a person has a digestive disorder such as ileitis, their body is unable to process food normally, and eating can become a stressful and sometimes painful chore. Let’s take a deeper look at this chronic condition that makes getting proper nutrition very difficult for those who are afflicted with it.

What Is Ileitis?

Ileitis is actually a form of Crohn disease, which is a chronic degenerative illness of the digestive tract. Ileitis specifically refers to Crohn that affects the ileum, and the term ileitis officially means “inflammation of the ileum.” Crohn disease can be found anywhere in the digestive tract, from the mouth down to the anus. The ileum is at the end of the small intestine, and ileitis is thus sometimes known as “terminal ileitis” because it is at the end (terminus) of the small intestine.

Ileitis, and Crohn in general, is a progressive disease that involves inflammation of the intestinal walls that may start out as minor and progress into more severe inflammation and ulcers that affects the deeper tissues of the intestinal tract and can even cause ruptures in the gut that lead to infection in other parts of the body. Blockage of the bowel, partial or total, is also a possible consequence of Crohn, and one of the more serious potential complications that at times is fatal.

The fact that the ileum is in the small intestine, where most of the body’s digestive work takes place, can make it one of the more troublesome spots for Crohn to form. The ileum is the most likely place to find Crohn in the small intestine. In order to avoid confusion with regard to terms, let’s take a brief look at the various ways that Crohn is classified. As we have stated, ileitis affects the ileum, the last (lowest) part of the small intestine. Ileocolitis is the most common form of Crohn disease overall, and it affects both the ileum and the large intestine which is also called the colon. Gastroduodenal Crohn affects the stomach and the first or top part of the small intestine, called the duodenum. Jejunoileitis is the term for inflammation of the jejunum, which is the top or first half of the small intestine. Crohn that inflames only the large intestine is called Crohn colitis or granulomatous. The basic design of the digestive system starts with the mouth and descends to the small intestine, then the large intestine or colon, and then the rectum where waste material leaves the body through the anus. I hope I haven’t confused you with all this anatomical terminology, but with all the differing terms it can be rather unclear to many folks.

The structure and purpose of the ileum make it a key part of the small intestine, and thus it can cause distinctive problems when it is inflamed by Crohn disease. The ileum is composed of many folds of tissue, and therefore contains a very large surface area. It plays a major role in the absorption of many important nutrients such as enzymes, proteins, and carbohydrates. When the ileum is irritated and thickened, as so often happens with ileitis, the patient can often eat enough of the right kinds of foods, and still not receive the nutrition he or she requires. This form of malnutrition is called malabsorption, and it is a common problem for folks with ileitis and other forms of Crohn disease.

What Are the Causes of Ileitis?

The exact cause of ileitis, and of Crohn disease in general, has not been positively identified. Crohn was first observed in the 1930’s by a doctor named Burrill Crohn. It is a rare disease in many parts of the world, but in affluent industrialized nations such as the United States, Crohn is more common. It is estimated that about 7 out of every 100,000 Americans is a victim of Crohn in its many forms. For this reason, a high-fat diet such as the Standard American Diet (SAD), combined with a sedentary lifestyle is suspected as an underlying cause of Crohn. That assumption is a pretty good bet, simply because most of the degenerative diseases of the Western nations are in truth the result of such poor dietary and lifestyle choices.

Recently, researchers have discovered another link to ileitis and Crohn. Evidence points to the fact that the inflammation associated with this illness may be the result of an inappropriate response from the immune system. These types of conditions are known as autoimmune diseases, and they occur because the immune system gets confused and mistakes healthy tissue as an infectious invader that needs to be sought out and destroyed. Thus, the immune system triggers inflammation in the healthy tissues. In this case, the ileum is the subject of the faulty immune system response. Other common autoimmune diseases include rheumatoid arthritis, lupus, and multiple sclerosis.

In the case of Crohn, it is thought that the immune system attacks the digestive system as an exaggerated response to a viral or bacterial infection. There is also a genetic component involved with Crohn, and this propensity for an autoimmune response may be related to certain genes that run in families. It is know for certain that if a close relative has struggled with ileitis or other forms of Crohn, that your own risk for the illness is increased.

Ileitis can attack persons of any age, race, or gender, but it is most commonly found in individuals between the ages of 15-30. When if forms in children, it can lead to complications such as stunted growth and delayed development as a result of malabsorption. The incidence of Ileitis or Crohn is slightly higher in males, and for reasons that are not well understood, it is 2-4 times more common in Jewish men living in certain parts of the world.

What Are the Signs and Symptoms of Ileitis?

Ileitis, and Crohn in general, is a progressive disease that often starts in the mucous membranes of the ileum. As time goes by, it invades deeper tissues , causing ulcers that penetrate other parts of the digestive tract. In the later stages of the disease, the bowel can be perforated and digestive products can invade parts of the body where they were never intended to be. An example of this is an infection of the lining of the abdomen called peritonitis, which is a serious illness that can potentially be life threatening.

Symptoms of Crohn will vary, depending on the location of the inflammation and the degree. Ileitis is one of the more common forms of Crohn, so many of these general signs apply to it. Here are some of the most typical symptoms:

  • Abdominal pain and cramping
  • Consistent watery diarrhea
  • Fever
  • Fatigue
  • Foul-smelling stools
  • Constipation
  • Loss of appetite
  • Weight loss
  • Fistulas (abscesses usually in the rectal area that may drain pus, mucous, or blood)
  • Painful bowel movements
  • Bloating and gas
  • Bloody stools or bleeding from the rectum
  • Joint pain
  • Swollen gums
  • Inflamed eyes
  • Difficulty with blood clotting
  • Kidney stones
  • Skin rashes
  • Liver inflammation or enlargement
  • Gastrointestinal bleeding

Are There Any Definitive Tests for Ileitis?

The symptoms for Crohn can be quite ambiguous at times, and they can also mimic other illnesses. There is no one test that can nail down a diagnosis of ileitis, but certain blood tests may be helpful:

  • Protein levels: Also known as an albumin test, this can measure the amount of protein in your blood and can indicate malabsorption of food and nutrients.
  • C-reactive protein and orosomucoid tests: These are good indicators of active inflammation within your body. Thus, they can indirectly point towards digestive disorders such as ileitis.
  • P-ANCA: This tests for the presence of certain antibodies that can help determine whether a patient has Crohn or ulcerative colitis, a related but distinctly different disease.

There are other procedures that your health care provider may also recommend to help determine a diagnosis, but these are quite invasive, and may expose you to harmful chemicals as well. I would only use them as a last resort, and be sure that whoever administers them is experienced as if they are not done correctly they can cause harm to your internal organs.

  • Endoscopy: This involves the insertion of a tube equipped with a light and a camera into your intestinal tract. When it is inserted into the lower digestive tract or large intestine, it is also called a colonoscopy. This procedure can exhibit areas of inflammation or ulceration related to Crohn.
  • Barium contrast study: The patient is given a dye composed of barium that highlights areas of the intestinal tract for better viewing via x-rays and other imaging technologies. Barium is a toxic chemical, and beware that some people may have serious allergic reactions to it.

What Treatments Are Available for Ileitis?

Mainstream medical providers often recommend, to no surprise, medications and surgery. Most of the time these anti-inflammatory drugs have limited success at treating ileitis, and some of them can have quite significant side effects. Antibiotics are also typically prescribed, but the problem with the use of antibiotics with chronic conditions such as Crohn is that they are given for long-term use, and this is very hard on the digestive tract. Antibiotics disrupt the natural balance of helpful flora in the gut, so it can actually make matters worse rather than better for ileitis patients.

Surgery can remove parts of the intestinal tract and reattach the ends, and in some cases, such as a bowel obstruction, surgery may be a life saving necessity. However, surgery does not cure the ileitis or Crohn, so it will most often return after surgery.

Are There More Natural Treatments Available?

Diet is the key word here. Folks with ileitis or Crohn have to be very careful what they eat. Here are a few suggestions:

  • Avoid spicy foods, as they tend to aggravate the inflammation.
  • Drink lots of pure water every day.
  • Try softer forms of foods such as cottage cheese, yogurt, and ricotta cheese.
  • Stay away from chunky, high fiber foods that are hard to digest. These only make your compromised digestive tract have to work harder.
  • Soups are a wonderful source of nutrition that can be very healthy and easy to digest. Homemade with fresh ingredients is the best.

Another suggestion would be the use of a quality, natural probiotic product that will help restore friendly bacteria to your gut. This will help you to digest more easily and to heal faster as well.

It is no coincidence that ileitis and Crohn are more common in affluent countries. As the saying goes, “you are what you eat.” The best way to avoid digestive disorders of all types is to develop life long patterns of dietary and lifestyle choices that lead towards overall wellness.

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