# The Ileum and Crohn's Disease



## David

Some of us prefer to put full faith in our doctors to properly treat us while others want to learn as much as they can about all aspects of the disease they have been diagnosed with in order to ensure they are receiving optimal care.  If you fall into the latter group and have been diagnosed with Crohn's Disease, learning about the Ileum is important as it is often affected by our good friend (and by good friend I mean we would happily stab them in the back and steal their significant other) Crohn's.  When your ileum is inflamed and you have Crohn's Disease, the subtype if called Ileitis.  If your colon is also inflamed, then your subtype is called Ileocolitis.

At 2-4 meters in length (one meter is 3 feet, 4 inches), the Ileum is the last (most distal) part of the small intestine and connects to the ceum by means of the Ileocecal valve. 







It's important to know if your ileum is affected by your Crohn's Disease because it is the part of the human anatomy tasked with absorbing fats and fat-soluble vitamins as well as [wiki]Vitamin B12[/wiki].  As such, one must often take fat-soluble vitamins that are water soluble if you have inflammation of the ileum or have had it resected. In addition, if you have inflammation in the Terminal Ileum (or at some point have your Terminal Ileum surgically removed) then you likely need to receive regular Vitamin B12 injections (typically every 1-3 months) as normal OTC supplementation will not be sufficient.  The ileum also takes part in Enterohepatic Circulation where bile salts secreted by the liver are reabsorbed and sent back for reuse.

If you have surgery that removed the jejunum and/or the duodenum, then the ileum is often able to adapt and take over their functions.  Unfortunately, the opposite is not true when your ileum is removed which is why resection of the duodenum and jejunum are usually tolerated much better than removal of the ileum.  

While most doctors are aware of the supplementation that should take place if the ileum is involved in your Crohn's Disease or resected, we here at crohnsforum.com have seen widespread evidence that suggests many patients are not being advised, given a proper treatment plan, or the patients do not properly adhere to the plan to their detriment.  The ileum is an incredibly important part of your digestive tract.  If yours is affected or removed, please discuss the above with your doctor to ensure the best possible outcome.

(Thank you so much to the members of Crohnsforum.com who helped write this article for the newsletter!)


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## CrohnsGuy

Thanks for the post! I had a bowel resection in early 2009 with part of my terminal ileum and part of the large colon removed during the process. I was never advised on any of these things which is disappointing to say the least; however, I have been medication-free since, so I must be doing something right.


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## David

Even if you feel great after the removal of your terminal ileum, I would still have your B12 levels checked somewhat regularly.  Thanks to enterohepatic circulation, the liver can store several years worth of vitamin B12.  There are many variables that go into how fast your stores are depleted and everyone will be different.


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## CrohnsGuy

Got it! I will ask my GI doc about it the next I go see him.


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## Crohny

(From my doctor) I have received no treatment plan, no information regarding Crohn's in my ileum, and no advice of any kind.
He said "you should probably have surgery"
He, and all others like him should retire.
I've learned so much on this forum- it has really helped me avoid surgery so far.


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