• Amir Mari, Tawfik Khoury, Mahmud Mahamid, Shorbaji Akram, Yael Kopelman, and Fadi Abu Baker.
• Department of Gastroenterology and Hepatology, Nazareth Hospital EMMS, Nazareth, Israel.
• Isr Med Assoc J. 2020 Nov 1; 11 (22): 684-687.

BackgroundWhile the routine performance of terminal ileum (TI) intubation during colonoscopy procedures is perceived to have a low yield, its utility during colonoscopies performed for specific indications have not been well studied.ObjectivesTo assess the diagnostic yield of an indication-based ileoscopy in real-life practice.MethodsThe authors reviewed endoscopic reports of patients who underwent colonoscopies over an 8-year period (2011-2018) and had routine ileoscopy during these procedures. Demographic data, indications for colonoscopy, and endoscopic findings were documented. Diagnostic yield and odds ratio for TI findings were calculated.ResultsOver 30,000 colonoscopy reports performed during the study period were reviewed. Ilesocopy was performed in 1800 patients, 216 patients had findings in the TI (ileitis or ulcers). TI findings were more prevalent in younger ages (38.3 ± 17.6 vs. 43.6 ± 20, P < 0.05). The greatest yield of ileoscopy was evident when performed for the evaluation of chronic abdominal pain and diarrhea (14.4% vs. 9.3%, odds ratio [OR] 1.62, P < 0.05). Positive fecal occult blood test (FOBT) (OR 0.1, 95% confidence interval [95%CI] 0.02-0.5, P = 0.005) and constipation (OR 0.44, 95%CI 0.2-0.9, P = 0.04) were negatively associated with TI findings.ConclusionsIleoscopy may have the greatest utility in evaluating suspected inflammatory bowel disease (IBD) patients, but may not add value to the evaluation of constipation and positive FOBT.

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