Prospective Observational Study, Prevalence of Various Lesions of Terminalileum in Patients Undergoing Colonoscopy

Background: The terminal ileum represents a clinically significant site frequently affected by diverse gastrointestinal pathologies. While inflammatory bowel diseases like Crohn's disease commonly involve this region, a broad spectrum of other conditions may present similarly, complicating diagnostic differentiation. Objective: This prospective observational study aimed to characterize the prevalence, etiology, and clinicopathological correlations of terminal ileal lesions identified during colonoscopy. Methods: Over a 20-month period at Sri Ramachandra Institute of Higher Education and Research, 101 patients with endoscopic evidence of terminal ileal ulcers underwent comprehensive evaluation. Analysis included clinical symptomatology, laboratory investigations, endoscopic characteristics, histopathological examination, and supplementary ultrasound imaging. Constipation (24%), abdominal pain (21%), diarrhea (19%). Ulcers with erythema/edema (60%), crypt abscesses (14%); infectious/non-specific inflammation > Crohn's disease prevalence. Conclusion: Terminal ileal pathology frequently stems from non-IBD etiologies, particularly infections and idiopathic inflammation. Accurate diagnosis necessitates integrated assessment of clinical, endoscopic, and histopathological features to prevent misdiagnosis of Crohn's disease and guide targeted therapeutic interventions.