After confirming the patient is not on NSAIDs, how do you approach acute ileitis on biopsies in a patient without symptoms or with only mild loose stools?

Is diarrhea inflammatory? What is her level of calprotectin? A useful biomarker to follow.

Aphthous ilieitis does not have risk features for progressive Crohn’s that, at least at this time, does not require an advanced agent. You can use symptomatic agents (loperamide, cholestyramine, etc.) to asses...

If it continues to be “acute” ileitis, then it is likely prep effect or something else causing acute intermittent inflammation, like aspirin, some supplement the patient is not telling you about, estrogen, and I would just monitor the patient. You have to have a therapeutic goal and budesonide does ...

“Persistent acute ileitis” is something of a paradoxical term that does not match up with the chronic features of Crohn’s disease disease. Absent crypt distortion, hewing of PMNs to crypt epithelium, or basal lymphoplasmacytosis with crypt shortfall, I would be reluctant to diagnose Crohn’s disease....