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Colonoscopy Question-Term Ileum

Today I had a new GI Doctor do a routine colonoscopy. When I woke up he said he wasn't able to get to the terminal ileum (which is where my CD is) and set me up for a small bowel series. The last 3 colonoscopies that I have had were able to get there and see and take pics, etc.

I thought this was strange.. has anyone else had this? I've had CD for 23 years, no surgeries, mild pain right now. Maybe he is more conservative?
 
It could be if you've had chronic inflammation in that area that there is narrowing or stricturing due to inflammation or scar tissue.

My son's inflammation was located in the TI, specifically at the ileocecal valve. His first two colonoscopit's the GI could get through the IC valve but a layer one he could not.
 

Scipio

Well-known member
Location
San Diego
Another possible explanation is that the new GI is not as skilled as the previous one in getting the probe into the terminal ileum. Like any physical task there is skill and practice involved. Many general GIs don't normally make a special effort to visualize the terminal ileum in routine non-IBD colonoscopies, which is another reason IMO to look for GIs who subspecialize in IBD. Because of their need to see the terminal ileum in a large proportion of their patients, they often get pretty good at getting the probe all the way there.
 
Hi, or your G.I is conscientious of doing a good job and does not want to force the scope. I would rather have a G.I who is careful ;)

It could mean scar tissue or inflammation. A small bowel series is pretty good at showing thickening, skip areas, stenosis (can look like a straightened pipe), and can give further detail of the whole 'small bowel' that a scope cannot reach.

Be well, God bless.
 
When I had my colonoscopy in May the doctor couldn't get the camera in (or identify the TI orifice) because of inflammation. That was made clear in the report. If you're not sure why he didn't go in, it could be worth a call to the team and asking, or ask them to clarify what it means.

Good luck!
 
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