Chronic Enteritis: Understanding Your Pathology Report

by Jason Wasserman MD PhD FRCPC
June 13, 2025

Chronic enteritis refers to long-lasting inflammation of the small intestine. When examining a tissue sample under a microscope, pathologists identify chronic enteritis by seeing increased numbers of specific immune cells, particularly lymphocytes and plasma cells. The presence of these immune cells means the inflammation has been present for an extended period—weeks, months, or even years.

What are the symptoms of chronic enteritis?

Symptoms of chronic enteritis can develop slowly over time and may include:

• Long-term (chronic) diarrhea, which can cause dehydration.

• Abdominal discomfort or persistent abdominal pain.

• Bloating and gas.

• Weight loss or difficulty gaining weight due to poor nutrient absorption.

• Fatigue or weakness, sometimes resulting from nutritional deficiencies.

Symptoms of chronic enteritis tend to persist or come and go over a longer period compared to active (acute) enteritis.

What causes chronic enteritis?

Several conditions can cause chronic enteritis, including:

• Inflammatory bowel disease (IBD): Conditions such as Crohn’s disease and ulcerative colitis commonly cause chronic inflammation of the intestine.

• Celiac disease: An autoimmune condition triggered by eating gluten, leading to long-term inflammation and damage to the intestine.

• Autoimmune disorders: Other autoimmune conditions, such as autoimmune enteropathy, may result in chronic inflammation.

• Medication or long-term treatments: Regular use of medications like non-steroidal anti-inflammatory drugs (NSAIDs) or previous radiation therapy can cause ongoing irritation and chronic inflammation of the intestine.

• Chronic infections: Some infections, particularly parasitic infections, can lead to persistent intestinal inflammation.

Your doctor will review your medical history, symptoms, and additional test results to determine the specific cause in your case.

What is the difference between chronic and active enteritis?

Pathologists classify enteritis into two types based on the type of immune cells seen and how long inflammation has lasted:

• Chronic enteritis: Long-lasting inflammation involving immune cells like lymphocytes and plasma cells. It usually indicates an ongoing condition such as inflammatory bowel disease or celiac disease, resulting in persistent symptoms like chronic diarrhea and nutritional deficiencies.

• Active enteritis: Short-term inflammation involving immune cells called neutrophils, typically indicating recent or ongoing injury, irritation, or infection. Active enteritis often presents with sudden symptoms like acute diarrhea and abdominal pain.

It is common for chronic and active inflammation to occur together, particularly if you have a chronic condition with flare-ups.

Why is identifying chronic enteritis important?

Recognizing chronic enteritis helps your doctor understand that the inflammation has been present for a longer period. This information is critical for diagnosing conditions that require long-term treatment and management. By identifying chronic enteritis, your doctor can recommend appropriate therapies, lifestyle changes, and dietary adjustments to help manage symptoms, improve nutrition, and reduce the risk of complications.

Questions to ask your doctor

• What is causing my chronic enteritis?

• Will I need additional tests to identify or confirm the underlying condition?

• What treatment options are available, and what do you recommend?

• How soon can I expect my symptoms to improve once treatment begins?

• Are there specific dietary or lifestyle changes that would help manage my condition?

• Should my family members be tested for related conditions, such as celiac disease?

• Will I need ongoing monitoring or regular check-ups?

• What symptoms should prompt me to seek medical attention quickly?