M Agrawal et al. Journal of Crohn’s and Colitis, jjab030, https://doi.org/10.1093/ecco-jcc/jjab030. Prevalence and progression of incidental terminal ileitis on non-diagnostic colonoscopy: a systematic review and meta-analysis

Key findings:

• Seven studies reported the prevalence of IDTI (Incidentally-diagnosed terminal ileitis) in 44,398 persons undergoing non-diagnostic colonoscopy
• The pooled prevalence rate of IDTI was 1.6%
• Progression to overt CD was rare over 1-7 years of followup

My take: As noted below by Dr. Rubin, in those with normal labs who are asymptomatic, most incidental ileitis is not progressive and should be monitored.