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While symptom-driven treatment guidelines that are steroid based are well established for pulmonary and few extrapulmonary manifestations (ie, cardiac, neurologic, renal), gastrointestinal sarcoidosis treatment is largely extrapolation with optimal management under investigation. Additionally, few works document small bowel obstruction related to small bowel sarcoidosis. We present a case of short-interval recurrent small bowel obstruction in a man in his sixties that revealed newly diagnosed sarcoidosis with suspected small bowel involvement who never underwent steroid therapy. The patient exhibited gastrointestinal symptoms, despite asymptomatic pulmonary disease and a course of prednisone may have reduced his risk of recurrence. We also review suggested gastrointestinal sarcoidosis treatment and surveillance guidelines with focus on the small bowel.<\/jats:p>","DOI":"10.1136\/bcr-2022-252486","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T12:48:30Z","timestamp":1669294110000},"page":"e252486","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Recurrent small bowel obstruction as a rare presentation of undiagnosed sarcoidosis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8648-6969","authenticated-orcid":false,"given":"Ashton A","family":"Naumann","sequence":"first","affiliation":[{"name":"Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9464-1471","authenticated-orcid":false,"given":"Vanessa I","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Shychuk","sequence":"additional","affiliation":[{"name":"Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"2025082723100552000_15.11.e252486.1","first-page":"3201","article-title":"Sarcoid of the testis","volume":"13","author":"Wong","year":"2006","journal-title":"Can J Urol"},{"key":"2025082723100552000_15.11.e252486.2","first-page":"101379","article-title":"A life-threatening small bowel obstruction as onset of an unknown sarcoidosis: a case report","volume":"33","author":"Paone","year":"2021","journal-title":"Respir Med Case Rep"},{"key":"2025082723100552000_15.11.e252486.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02202.x"},{"key":"2025082723100552000_15.11.e252486.4","first-page":"377","article-title":"Pathological studies on sarcoidosis autopsy. 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