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Backwash Ileitis
Backwash ileitis, an inflammation of the terminal ileum secondary to ulcerative colitis, requires specialized care. At GastroDoxs in Houston, Dr. Nghia Nguyen offers personalized diagnosis, advanced treatments, lifestyle guidance to manage symptoms, prevent complications, and improve patients' quality of life.
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
What Is Backwash Ileitis?
Backwash ileitis is mild inflammation of the terminal ileum that occurs when ulcerative colitis in the colon “washes back” into the last part of the small intestine. It is distinct from Crohn's disease and is managed with treatments tailored to ulcerative colitis.
Common Causes and Risk Factors
Ulcerative colitis extending beyond the colon into the ileum
Severe or frequent flare-ups of ulcerative colitis
Long duration of ulcerative colitis or diagnosis at a young age
Family history of inflammatory bowel disease (IBD)
Signs and Symptoms
Diarrhea, sometimes mixed with blood
Pain or cramping in the lower right abdomen
Urgent need to have a bowel movement
Unintended weight loss
Persistent fatigue or weakness
How Dr. Nghia Nguyen Diagnoses Backwash Ileitis?
Dr. Nguyen uses a step-by-step approach:
Medical History and Physical Exam
She reviews your ulcerative colitis history, current symptoms (including epigastric discomfort), medication use, and family history. A focused abdominal exam checks for tenderness in the lower right quadrant and epigastric area.
Endoscopic Evaluation
A full colonoscopy with terminal ileum intubation is performed. Dr. Nguyen inspects the mucosa for mild inflammation (“backwash”) and takes small tissue biopsies to confirm ileitis and rule out Crohn's disease.
Blood Tests and Stool Studies
Complete blood count (CBC) to detect anemia or elevated white cells.
Inflammatory markers (CRP, ESR) to gauge disease activity.
Stool cultures and C. difficile toxin assay to exclude infection.
Imaging Studies
MRI or CT enterography to visualize the small bowel and differentiate backwash ileitis from Crohn's involvement.
Advanced Testing (if needed)
In select cases, capsule endoscopy or specialized small-bowel biopsies help evaluate deeper lesions or unclear findings.
Treatment
Our Team offers a full range of care for backwash ileitis.
1. Lifestyle and Diet Modifications
Eat a low-residue diet to calm your bowel
Have small, frequent meals throughout the day
Stay well hydrated with plenty of water
Incorporate stress-reduction techniques such as yoga or meditation
2. Medications
Aminosalicylates (5-ASA) to reduce mild inflammation
Corticosteroids for rapid control of flare-ups
Immunomodulators to maintain remission
Biologics to target and stop harmful immune responses
3. Minimally Invasive or Advanced Procedures
Endoscopic dilation to open narrowed areas near the ileocecal valve
Laparoscopic surgery for persistent or severe flare-ups
Collaboration with specialized IBD surgeons when surgical intervention is required
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Frequently Asked Questions
What is backwash ileitis?
Backwash ileitis is mild inflammation of the terminal ileum that occurs when ulcerative colitis extends beyond the colon into the last segment of the small intestine.
How is backwash ileitis different from Crohn's disease?
Backwash ileitis is secondary to ulcerative colitis and affects only the terminal ileum's lining. Crohn's disease can involve any part of the GI tract and penetrates deeper into the bowel wall.
Can diet and lifestyle changes alone treat backwash ileitis?
Dietary adjustments (low-residue foods, small frequent meals, hydration) and stress reduction help manage symptoms but are best combined with medication for full control.
How long does treatment for backwash ileitis take?
Most patients see symptom relief in 4-6 weeks with proper medical therapy. Severe cases or complications may require a longer course or procedural intervention.
Do I need regular colonoscopies if I have backwash ileitis?
Yes. Regular colonoscopic surveillance monitors disease progression, detects backwash ileitis, and screens for complications such as strictures or dysplasia.
Will my insurance cover tests and treatments?
Many insurance plans cover colonoscopies, lab work, imaging, and prescribed IBD medications. Our staff works with you to verify benefits and maximize coverage.
