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Backwash Ileitis
Backwash ileitis, a form of ulcerative colitis, inflames the ileum, causing pain, diarrhea, fatigue and weight loss. At GastroDoxs in Houston, Dr. Scott employs advanced diagnostics and personalized, comprehensive, tailored therapies-including medications, diet plans and procedural interventions-to manage symptoms effectively.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Common Causes and Risk Factors
Active ulcerative colitis that extends into the ileum
Chronic or severe inflammation of the colon
Family history of inflammatory bowel disease (IBD)
Genetic variants affecting immune regulation
Signs and Symptoms
Pain or tenderness in the lower right abdomen
Watery diarrhea, often with blood
Persistent fatigue or general weakness
Cramping and sudden urges to use the restroom
Unintended weight loss over time
How Dr. Scott Diagnoses This Condition?
Dr. Scott uses a step-by-step approach:
Medical History and Physical Exam
He reviews your ulcerative colitis history, onset of epigastric pain, family history of IBD, medication use and performs an abdominal exam-focusing on tenderness in the epigastrium and right lower quadrant.
Blood Tests and Stool Studies
We check a complete blood count for anemia, ESR and CRP for systemic inflammation, and stool studies (culture, calprotectin) to exclude infection and gauge intestinal inflammation.
Endoscopic Evaluation
Colonoscopy with ileoscopy to directly visualize the colon and terminal ileum for signs of backwash ileitis.
Targeted biopsies of the ileum to distinguish backwash changes from Crohn's disease.
Cross-Sectional Imaging
MRI enterography or CT scan to assess the extent of small-bowel involvement, wall thickening, and to rule out complications like strictures or abscesses.
Advanced Testing (if needed)
In select cases, capsule endoscopy or small-bowel follow-through may be used to evaluate areas beyond the reach of standard scopes.
Treatment
Our Team offers a full range of care for backwash ileitis.
1. Lifestyle and Diet Modifications
Low-fiber (low-residue) diet during flare-ups to ease bowel movements
Smaller, more frequent meals focused on soft, cooked foods
Hydration with water and electrolyte-rich fluids
Relaxation methods such as meditation or deep breathing
2. Medications
We follow the latest IBD treatment guidelines for ileitis.
Aminosalicylates (5-ASA) to reduce inflammation
Short-term corticosteroids for acute flare control
Immunomodulators to regulate the immune response
Biologics for moderate to severe disease
3. Minimally Invasive or Advanced Procedures
Endoscopic dilation for strictures or narrowing in the ileum
In-office biologic infusions at our Houston outpatient center
Surgical consult and intervention for rare, severe cases
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What is the difference between backwash ileitis and Crohn's disease?
Backwash ileitis is inflammation of the ileum caused by ulcerative colitis spreading backward, whereas Crohn's can start in the ileum and affect any part of the digestive tract.
When can I expect symptom relief?
Most patients feel better within 2 to 4 weeks after starting prescribed medications and making recommended diet changes under Dr. Scott's guidance.
Can diet alone manage backwash ileitis?
Dietary adjustments help ease symptoms, but medication is usually necessary to fully control inflammation and prevent flares.
Are biologic therapies safe?
Yes. Biologics are FDA-approved treatments that Dr. Scott monitors closely to ensure safety and effectiveness for moderate to severe cases.
Will I need surgery for backwash ileitis?
Surgery is rare and only considered when other treatments fail to control symptoms or complications arise.
How often should I have a colonoscopy?
Dr. Scott typically recommends a follow-up colonoscopy every 1 to 2 years, depending on how active your disease is and your individual risk factors.
