Abstract
ObjectiveTo assess the factors associated with the progression of isolated terminal ileal lesions (ITILs) at colonoscopy in Chinese patients.MethodsPatients diagnosed with ITILs were enrolled. The ileoscopy was performed by two experienced gastroenterologists every 52 weeks. A logistic regression analysis was used to elucidate the factors associated with Crohn's disease (CD) and mucosal healing. A log rank test was used to assess the differences of the cumulative proportion of CD and mucosal healing in different groups at different times.Results(1) A total of 34 patients were included and no patient had taken nonsteroidal anti-inflammatory drug in the last 6 months; eight (23.5%) patients had a clinical diagnosis of CD, 14 (41.2%) patients achieved mucosal healing, and 12 (35.3%) patients showed no significant changes in the lesions at last follow-up. (2) The logistic regression analysis showed that only abdominal pain was a factor in the ITIL disease outcomes. (3) The cumulative proportion of CD in the abdominal pain group after 3 years was statistically higher than that in the non-abdominal pain group (42.7% vs. 6.2%, χ2 = 10.129, P = 0.001). However, the cumulative proportion of mucosal healing in the non-abdominal pain group was statistically higher than that in the abdominal pain group (73.3% vs. 5.6%, χ2 = 5.225, P = 0.022). (4) The numbers of lesions observed on the initial colonoscopy exams and the initial histologic findings were not related to the ITIL disease outcomes.ConclusionsClinical symptoms may be related to ITIL disease outcomes. Patients with abdominal pain had a high likelihood of CD, whereas those without abdominal pain had a high likelihood of mucosal healing.
Highlights
Clinical symptoms may be related to isolated terminal ileal lesions (ITILs) disease outcomes
Patients with abdominal pain had a high likelihood of Crohn’s disease (CD), whereas those without abdominal pain had a high likelihood of mucosal healing
Ileal intubation is increasingly recognized as being valuable in patients with abdominal pain, diarrhea or bloody stools— where inflammatory bowel disease is a consideration. [1,2,3] This has led to an increased identification of patients who are not classified—those with Isolated ileal abnormalities, which we have coined isolated terminal ileal lesions (ITILs). [4,5] It is likely that a proportion of these patients are suffering from a restricted form or so-called forme fruste of Crohn’s disease (CD)
Summary
Ileal intubation is increasingly recognized as being valuable in patients with abdominal pain, diarrhea or bloody stools— where inflammatory bowel disease is a consideration. [1,2,3] This has led to an increased identification of patients (about 0.1–0.3%) who are not classified—those with Isolated ileal abnormalities, which we have coined isolated terminal ileal lesions (ITILs). [4,5] It is likely that a proportion of these patients are suffering from a restricted form or so-called forme fruste of Crohn’s disease (CD). Ileal intubation is increasingly recognized as being valuable in patients with abdominal pain, diarrhea or bloody stools— where inflammatory bowel disease is a consideration. [1,2,3] This has led to an increased identification of patients (about 0.1–0.3%) who are not classified—those with Isolated ileal abnormalities, which we have coined isolated terminal ileal lesions (ITILs). [4,5] It is likely that a proportion of these patients are suffering from a restricted form or so-called forme fruste of Crohn’s disease (CD). The clinical significance of this entity is unclear. The present study evaluated the clinical course of patients with ITILs to determine the clinical significance of these lesions The clinical significance of this entity is unclear. [2,6,7].
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