Endoscopic Findings and Diagnosis of Other Inflammatory Bowel Diseases of the Lower GI Tract

Abstract

While Crohn’s disease is the representative and the most frequent inflammatory bowel disease of the small bowel, there are other diseases characterized by small bowel mucosal lesions. Cryptogenic multifocal ulcerous stenosing enteritis is one of those diseases, initially reported in the European area in the 1970s and becoming widely recognized in the beginning of this century. The disease has been characterized by chronic or relapsing ulcers of nonspecific histology in the jejunum and the ileum, and it has been suggested that it may be associated with vasculitis. There has also been a clinical entity of chronic small bowel ulcers referred to as chronic nonspecific multiple ulcers of the small intestine (CNSU). The disease has become widely accepted as a clinical entity in the Japanese population. CNSU is clinically characterized by chronic and obscure intestinal bleeding and extraordinarily peculiar small-bowel ulcers of nonspecific pathology. The ileum other than the terminal ileum is affected by sharply demarcated, ill-shaped shallow ulcers restricted to the submucosal layer. These conditions should seriously be considered in patients with chronic and intractable small-bowel ulcers.