{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:09:01Z","timestamp":1774580941602,"version":"3.50.1"},"reference-count":58,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Backwash ileitis (BWI) refers to inflammation in the distal ileum in patients with extensive ulcerative colitis (UC) that is thought to be caused by a \u201creflux\u201d or \u201cbackwash\u201d of colonic contents. In the absence of well-defined diagnostic criteria for BWI, more recently, the term UC-associated ileitis was proposed in favor of the backwash theory, which questions the existence of backwash ileitis as a distinct disease-specific subset of patients. Moreover, distinguishing UC-associated BWI from terminal ileitis of Crohn\u2019s disease or other conditions could be a diagnostic challenge and significantly affect treatment management. Therefore, clinical, endoscopic, histologic, and imagistic diagnostic features may aid in making this distinction. This literature review related to BWI outlines the hypothesis that the ileum may also become involved in UC as a primary manifestation of UC based on recent findings. This study also highlights the possibility that associated ileitis in UC patients may represent a potential risk factor for neoplasia, a positive association with primary sclerosing cholangitis, and a higher risk for the subsequent development of pouchitis after restorative proctocolectomy. It synthesizes recent key findings and highlights areas for further research.<\/jats:p>","DOI":"10.3390\/life15040567","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T05:43:33Z","timestamp":1743572613000},"page":"567","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Backwash Ileitis\u2014From Pathogenesis to Clinical Significance: Literature Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1694-3970","authenticated-orcid":false,"given":"Alina-Ecaterina","family":"Jucan","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Otilia","family":"Nedelciuc","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6226-2196","authenticated-orcid":false,"given":"Vasile-Claudiu","family":"Mihai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Dranga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6566-4388","authenticated-orcid":false,"given":"Mihaela-Cristiana","family":"Andronic","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona-Stefania","family":"Juncu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgiana-Elena","family":"Sarbu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana-Ruxandra","family":"Mihai","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8314-0997","authenticated-orcid":false,"given":"Andrei","family":"Andronic","sequence":"additional","affiliation":[{"name":"Discipline of Medical Semiology, Medical Department I, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Ciortescu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7596-2656","authenticated-orcid":false,"given":"Vasile","family":"Drug","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Cijevschi Prelipcean","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-9224","authenticated-orcid":false,"given":"Catalina","family":"Mihai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Department of Gastroenterology, Saint Spiridon County Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/ecco-jcc\/jjad142","article-title":"Definitions of Histological Abnormalities in Inflammatory Bowel Disease: An ECCO Position Paper","volume":"18","author":"Feakins","year":"2024","journal-title":"J. Crohns Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cicerone, C., D\u2019Amico, F., Allocca, M., Zilli, A., Parigi, T.L., Danese, S., and Furfaro, F. (2024). A Comprehensive Multidisciplinary Approach to Diagnosing Chronic Inflammatory Bowel Diseases: Integration of Clinical, Endoscopic, and Imaging Modalities. 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