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Ileoscopy at colonoscopy is a simple maneuver, which confirms the completeness of the procedure and improves the diagnostic yield. With an increasing number of ileal intubations, it is not uncommon to detect single or multiple ulcers in the terminal ileum 1 2 3. In patients with ileal and/or ileocolonic involvement on imaging modalities, these Ileitis, defined as inflammation of the ileum, is classically caused by Crohn's disease (CD). However, a wide variety of diseases may be associated with ileitis. These include infectious diseases, spondyloarthropathies, vasculitides, ischemia, neoplasms, drug-related, eosinophilic enteritis, sarcoidosis, amyloidosis, and a variety of other Inflammation is noted in the terminal ileum in less than 17% of individuals affected by UC. The inflamed areas are frequently limited to the terminal 10 to 15 cm of the ileum (â³backwash ileitisâ³). It could also be an early presentation of the ulcerative colitis, which may also involve the upper part of the gastrointestinal tract (13-15). Terminal Ileitis Symptoms. Symptoms of terminal ileitis vary, but may include: Lower abdominal pain and cramps. Diarrhea. Bloody diarrhea. It's important to keep in mind that symptoms like cramping and diarrhea can happen for a variety of reasons. However, chronic inflammation of the ileum might cause these symptoms to linger. Jejunoileal fold pattern reversal (a.k.a. jejunization of the ileum) is one of the signs of celiac disease, and is seen on small bowel follow-through studies, CT and MRI 1-4.The pattern is one of increased number of ileal folds and reduced number of jejunal folds 1,2, and is considered