Backwash Is Hogwash: The Clinical Significance of Ileitis in Ulcerative Colitis

@article{Patil2017BackwashIH,
  title={Backwash Is Hogwash: The Clinical Significance of Ileitis in Ulcerative Colitis},
  author={Deepa T. Patil and R. Odze},
  journal={The American Journal of Gastroenterology},
  year={2017},
  volume={112},
  pages={1211-1214}
}
INTRODUCTION Up to 35% of patients with ulcerative colitis (UC) develop infl ammation in the terminal ileum, which historically, has been attributed to backwash of colonic contents into the terminal ileum, a condition termed “backwash ileitis” (BWI) ( 1–5 ). Th e hypothetical mechanism for this phenomenon is that when infl ammation of the proximal cecum/ileocecal mucosa is severe enough, it may cause malfunction of the ileocecal junction (ICJ) and retrograde fl ow of colonic contents into the… Expand
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  • P. Giuffrida, A. Vanoli, +15 authors A. Di Sabatino
  • Medicine
  • Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • 2018
BACKGROUND Inflammatory bowel disease (IBD) is associated with neuroendocrine cell hyperplasia. AIMS We investigated neuroendocrine cells in J-pouches of patients with ulcerative colitis undergoingExpand
Biopsy diagnosis of colitis: an algorithmic approach
TLDR
This review will focus on a pattern-based algorithmic approach to evaluating biopsies of patients who present to physicians with signs and symptoms of colitis, to distinguish variations in normal mucosa and biopsy procedure-related artifacts from true inflammatory conditions. Expand
Daily Dilemmas in Pediatric Gastrointestinal Pathology.
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3 diagnostic challenges that are often encountered in daily practice are outlined; these include eosinophilic diseases, duodenal intraepithelial lymphocytosis with preserved villous architecture, and terminal ileal inflammation in the setting of idiopathic inflammatory bowel disease. Expand
Ulcerative Colitis: Making the Diagnosis.
TLDR
Although laboratory and radiographic findings can aid in the diagnosis of ulcerative colitis, endoscopy remains the gold standard for diagnosis. Expand
Microscopic/"Backwash" Ileitis and Its Association With Colonic Disease in New Onset Pediatric Ulcerative Colitis.
TLDR
Patients with new onset UC may have microscopic ileal inflammation at time of diagnosis, even if the terminal ileum appears macroscopically normal, and children with microscopic ilesitis in the context of UC do not need to be reclassified as "indeterminate colitis" or Crohn disease. Expand

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Ileal changes in UC are generally mild in nature (villous atrophy, increased inflammation, scattered crypt abscesses), and are not associated with an increased rate of ileo-anal pouch complications, dysplasia, or carcinoma, and some cases are consistent with a backwash etiology. Expand
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