Aspecific ileitis: Crohn's disease or not Crohn's disease? A prospective study.
OBJECTIVE
It is not clear whether aspecific ileitis may represent an early manifestation or a milder variant of Crohn's disease or not. The aim of this study was to evaluate the clinical outcomes of aspecific ileitis.


METHODS
Subjects with at least one of the following signs at retrograde ileoscopy: erythema, nodularity, aftae, erosions, and ulcers were considered. They should not have had defined gastrointestinal disease, biochemical signs of inflammation, use of drugs, celiac disease, and intestinal infectious disease.


RESULTS
We enrolled 51 subjects (22 men), mean age (± SD) at colonoscopy of 41.1 ± 13.1 years. Indications to colonoscopy were overt or occult intestinal bleeding (18), diarrhoea (15), systemic signs (10), IBS-like symptoms (5), other (3). Ileal lesions were ulcers (9), erosions (26), aftae (10), nodularity (3), and erythema (3). At histological evaluation aspecific findings were observed. Forty-four out of 51 (86.3%) subjects underwent further investigations of small bowel. Second colonoscopy was performed in 31 (60.8%) persisting symptomatic subjects: ileitis was confirmed in 14 (46.6%). Ten out of 51 (19.6%) were eventually diagnosed as affected by Crohn's disease.


CONCLUSIONS
A substantial proportion of subjects with endoscopic and histological findings of aspecific ileitis is eventually diagnosed as affected by Crohn's disease. In these subjects, a strict follow-up is strongly recommended.
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
Cristina
C
Bezzio
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
Ilaria
I
Arena
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
Massimo
M
Devani
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
Barbara
B
Omazzi
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy.
Gianpiero
G
Manes
Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho, Milan, Italy. saibo@tiscali.it.
Simone
http://orcid.org/0000-0001-5677-2534
S
Saibeni
D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis*; D003710:Demography; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007079:Ileitis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
Crohn’s disease; Ileitis; Ileo-colonoscopy; Inflammatory bowel disease