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Updated: Jun 1, 2026

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Published on: August 26, 2014
Diagnostic value of terminal ileum biopsy in chronic diarrhea with normal endoscopic appearance
Abdurrahim Sayilir1, Mevlüt Kurt, Murat Kekilli
1Department of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Kizilay Sk. no. 2, Sihhiye, Ankara, Turkey. drabdurrahim@gmail.com
Objective:
To investigate the diagnostic value of a terminal ileum biopsy in chronic non-bloody diarrhea with normal endoscopic appearance.
Methods:
Patients who had a terminal ileum biopsy performed between January 2007 and January 2010 during a colonoscopy despite normal endoscopic appearance were reviewed. They were divided into two groups according to the indication for the colonoscopy: non-bloody diarrhea and non-diarrhea; and their histopathological findings were compared.
Results:
By screening the colonoscopy records, 473 patients were found to have had a terminal ileum biopsy. Of these patients, 178 were excluded for various reasons. Finally, 295 patients were suitable for analysis. The non-bloody diarrhea group consisted of 135 patients, while the remaining 160 patients constituted the non-diarrhea group. A histopathological examination of the terminal ileum biopsy specimens in the non-bloody diarrhea group revealed an abnormal histology in eight patients (5.9%), compared with five patients (3.1%) in the non-diarrhea group. No statistically significant difference was found between the two groups (P=0.26).
Conclusion:
Although performing a biopsy of the terminal ileum despite a macroscopically normal appearance may offer some additional benefit to the diagnosis of chronic non-bloody diarrhea, prospective trials are needed for assessing the diagnostic value of a terminal ileum biopsy in patients with chronic diarrhea.
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