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Backwash Ileitis

Backwash ileitis, a complication of ulcerative colitis where colon waste irritates the ileum, can cause pain, diarrhea, and nutrient deficiencies. At GastroDoxs in Houston, Dr. Bharat Pothuri employs advanced diagnostics and personalized treatments, guiding patients toward relief and intestinal health.

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Bharat Pothuri

About the Expert

Dr. Bharat Pothuri is a board-certified gastroenterologist and the founder of GastroDoxs. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Common Causes and Risk Factors

  • Ulcerative colitis with severe colon inflammation
  • Backflow of colonic contents into the terminal ileum
  • Altered bowel flow after colon surgery
  • Family history of inflammatory bowel disease
  • Onset most often in young adults
  • Chronic inflammation of the large intestine

Signs and Symptoms

  • Lower right abdominal pain and cramping
  • Frequent diarrhea, sometimes with blood or mucus
  • Urgent need to use the restroom
  • Fatigue, weakness, or malaise
  • Unintended weight loss
  • Signs of poor nutrient absorption (e.g., anemia)

Expert Treatment for Backwash Ileitis by Dr. Bharat Pothuri

Dr. Pothuri uses a comprehensive, step-by-step approach:

Medical History and Physical Exam

He reviews your ulcerative colitis history, symptom onset, family history of IBD, and any epigastric discomfort. A focused abdominal exam checks for tenderness in the right lower quadrant and upper abdomen.

Blood and Stool Tests

We measure inflammatory markers (CRP, ESR), complete blood count for anemia, metabolic panel for nutrition, and stool studies for infection and fecal calprotectin.

Colonoscopy with Ileal Intubation

  • Direct visualization of the colon and terminal ileum to identify backwash ileitis changes-redness, edema, ulcerations.
  • Targeted biopsies of the ileum and colon to confirm histopathology and rule out Crohn's disease.

Cross-Sectional Imaging

  • MR Enterography or CT Enterography to assess the small bowel and rule out other causes of epigastric pain.
  • Abdominal ultrasound, when indicated, to evaluate adjacent organs (gallbladder, pancreas).

Advanced Diagnostics (if needed)

Capsule endoscopy or small-bowel MRI enterography may be used in complex cases to evaluate deeper small-intestinal involvement.

Dr. Bharat Pothuri
Treatment

Our Team offers a full range of care for backwash ileitis.

1. Diet and Lifestyle Changes

  • Personalized low-residue diet to ease digestion and reduce irritation
  • Hydration plans to prevent dehydration during flare-ups
  • Smaller, more frequent meals to support nutrient absorption
  • Stress-management techniques (walking, breathing exercises, support groups)

2. Medications

  • 5-ASA agents (e.g., mesalamine) for mild inflammation control
  • Short-term corticosteroids to manage acute flare-ups
  • Immunomodulators to regulate an overactive immune response
  • Biologic therapies targeting specific proteins in moderate to severe cases

3. Procedures and Advanced Care

  • Endoscopic delivery of targeted treatments (lidocaine, steroids) to inflamed areas
  • Surgical intervention in rare cases to remove extensively damaged colon segments
2.3K

Patients Treated

Dr. Pothuri has treated more than 2.3K patients, helping individuals improve their digestive health and overall well-being through expert, personalized care.

20Y

Years of Experience

With over 20 years of experience, GastroDoxs has been a trusted provider of gastroenterology care, focusing on delivering the best outcomes for patients

Bharat Pothuri

About the Author

Dr. Bharat Pothuri is a Board-Certified Gastroenterologist and Hepatologist. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Frequently Asked Questions

What is the difference between backwash ileitis and Crohn's disease?

Backwash ileitis occurs when inflammation from ulcerative colitis extends into the terminal ileum. Crohn's disease can affect any part of the digestive tract and typically involves deeper, transmural inflammation.

How do I know if my symptoms are from ulcerative colitis or backwash ileitis?

A colonoscopy with biopsy is the gold standard. If inflammation is continuous from the colon into the ileum, it suggests backwash ileitis rather than isolated ulcerative colitis.

Can diet alone treat this condition?

While dietary changes can ease symptoms, they do not stop the underlying inflammation. Most patients require medication in addition to diet and lifestyle modifications.

Is backwash ileitis the same as ulcerative colitis?

No. Ulcerative colitis affects only the colon. Backwash ileitis refers specifically to inflammation -washing back- into the ileum as a result of severe colonic disease.

What happens if I don't treat backwash ileitis?

Untreated inflammation can lead to malabsorption, nutrient deficiencies, weight loss, and an increased risk of complications over time.

How often should I see Dr. Pothuri?

Most patients are monitored every 3 to 6 months, with more frequent visits during flare-ups or medication adjustments.

Where can I learn more?

For trusted resources and support, visit the Crohn's & Colitis Foundation at https://www.crohnscolitisfoundation.org.

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