The necessity of routine terminal ileum intubation in patients undergoing routine colonoscopy: Is it a must?

Objectives Terminal ileal intubation (TIE) is a useful procedure during colonoscopy, but its clinical value is controversial in the literature. The aim of this study is to investigate the necessity of terminal ileal intubation during colonoscopy in patients not suspected of having inflammatory bowel disease. Methods This study was conducted by retrospectively reviewing data from 872 colonoscopies. Patients with inflammatory bowel disease and those with inadequate bowel preparation were excluded from the study. The demographic data of the patients, colonoscopy results, macroscopic and microscopic findings, and complications were recorded. Results The average age of the 763 patients included in the study was 53.26±23.82 years, with 429 (56.22%) male and 334 (43.78%) female patients. A total of 107 patients (14.02%) underwent TIE. Of the 107 patients who underwent TIE, 56 (52.33%) were female, and 51 (47.67%) were male, with an average age of 49.52±21.69 years. The colonoscopy indications for patients who underwent TIE were diarrhea in 46 patients, rectal bleeding in 38 patients, and abdominal pain in 23 patients. Macroscopic pathological findings were observed in 8 patients (7.46%), and microscopic pathological findings in 3 patients (2.80%). The proportion of patients with microscopic pathological findings accounted for 0.39% of all colonoscopies. Conclusions Our study suggests that while TIE, which requires experience and extends the duration of colonoscopy, may be beneficial for the diagnosis of selected patients, it may not be necessary in routine colonoscopies given its very low diagnostic value.