Actor Jasmin Bhasin’s recent health scare has drawn attention to a condition that is unfamiliar to many but can cause significant intestinal inflammation if left untreated. The television actor was hospitalised during a trip to Dubai after developing severe abdominal symptoms and later revealed that she had been diagnosed with terminal ileitis along with a severe intestinal infection and that she is still not out of the woods.
Her diagnosis has also prompted questions about what terminal ileitis actually is and whether it is a disease in itself. “Terminal ileitis is an inflammatory condition affecting the end of the small intestine (hence terminal) before it attaches to the large intestine, i.e., large bowel or colon. The vast majority of terminal ileitis cases occur in people aged 15 to 35 years old, although it can occur in older adults as well,” says Dr Sanjay Kumar, senior director, gastroenterology, Max Super Speciality Hospital, Noida. Excerpts:
What is terminal ileitis?
Terminal ileitis refers to inflammation of the terminal ileum, the last section of the small intestine before it joins the large intestine. This part of the bowel is responsible for absorbing nutrients such as vitamin B12 and bile acids, making it an important component of the digestive system. The condition is not a diagnosis but rather a finding that indicates inflammation in a specific part of the intestine. The next step is to determine what has caused that inflammation, as the treatment depends entirely on the underlying condition.
Terminal ileitis is a descriptive term rather than a disease. Once we identify inflammation in the terminal ileum, the focus shifts to understanding whether it has been caused by an infection, an inflammatory bowel disease, medication or another condition.
What causes inflammation in the terminal ileum?
Terminal ileitis can occur for several reasons. One of the most well-known causes is Crohn’s disease, a chronic inflammatory bowel disease that can affect any part of the digestive tract but frequently involves the terminal ileum. However, infections caused by bacteria such as Salmonella, Campylobacter and Yersinia can produce similar inflammation, as can certain viral infections.
Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), including commonly used painkillers, has also been linked to irritation of the small intestine. In less common cases, reduced blood flow to the bowel, intestinal tuberculosis, autoimmune disorders and even certain cancers may be responsible. The symptoms can look deceptively similar across different conditions.
What symptoms should people watch for?
The symptoms of terminal ileitis often resemble those of a severe stomach infection, making it difficult for patients to distinguish between the two without medical evaluation. Persistent pain in the lower right side of the abdomen is among the most common complaints. Many patients also experience diarrhoea, nausea, vomiting, fever, fatigue and loss of appetite. Some may notice unexplained weight loss or blood in the stool, particularly if the inflammation is severe.
While mild infections may resolve with appropriate treatment, symptoms that persist or recur should not be ignored, doctors caution.
How is the condition diagnosed?
Since terminal ileitis is only the starting point rather than the final diagnosis, doctors usually recommend a series of investigations to identify the underlying cause. Blood tests can reveal signs of inflammation or infection, while stool tests may detect bacteria or other pathogens. Imaging studies such as colonoscopy with biopsy, CT scans or MRI help assess the extent of intestinal involvement, and a colonoscopy allows doctors to directly examine the terminal ileum. In many cases, small tissue samples are also taken for biopsy to confirm the diagnosis.
These tests help distinguish between temporary infectious causes and chronic inflammatory diseases that require long-term management.
Can terminal ileitis be treated?
The outlook depends largely on what has caused the inflammation. If a bacterial infection is responsible, antibiotics and supportive care are often enough to achieve complete recovery. However, patients diagnosed with Crohn’s disease may require anti-inflammatory medications, corticosteroids, immunosuppressive drugs or biologic therapies to control ongoing inflammation and prevent future flare-ups.
In more severe situations, particularly when complications such as bowel obstruction, abscesses or perforation develop, surgery may become necessary. The earlier the underlying cause is identified, the better the chances of preventing long-term complications. Delayed treatment can allow inflammation to progress and damage the intestine.
Living with the condition
Recovery varies considerably depending on the diagnosis. Patients with infection-related terminal ileitis often recover fully once the infection resolves. Those living with inflammatory disease however, may need lifelong monitoring because the condition tends to alternate between periods of remission and flare-ups.
Doctors generally recommend maintaining adequate hydration, following a balanced diet that avoids individual food triggers, taking prescribed medications regularly and attending scheduled follow-up appointments. Smoking is a no-no as tobacco use has been shown to worsen disease activity. Monitoring nutritional deficiencies, especially vitamin B12 and iron, also forms an important part of long-term care.
What are the risks if it is left untreated?
Persistent inflammation in the terminal ileum can lead to serious complications over time. Chronic inflammation may cause narrowing of the intestine, increasing the risk of bowel obstruction. Some patients develop fistulas—abnormal connections between different parts of the intestine or nearby organs—or abscesses that require surgical treatment. Ongoing inflammation can also interfere with nutrient absorption, resulting in vitamin deficiencies, anaemia, weight loss and malnutrition.
When should you seek medical attention?
Persistent abdominal pain, diarrhoea lasting more than a few days, blood in the stool, repeated vomiting, high fever, unexplained weight loss or signs of dehydration all warrant prompt medical evaluation. While many gastrointestinal infections resolve on their own, these symptoms may also signal inflammatory bowel disease or another condition that requires specialist care.
Jasmin Bhasin’s diagnosis of terminal ileitis has highlighted the importance of recognising the symptoms of this inflammatory intestinal condition and seeking timely treatment. (Credit: instagram/@jasminbhasin2806, Image enhanced using AI) 
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