We report a 31-year-old patient with intestinal spirochetosis. Colonoscopy revealed edematous mucosa with multiple erythematous spots in the proximal colon. Barium enema examination demonstrated marked edema with luminal narrowing and thumb-printing predominantly in the ascending colon. Numerous spirochetes were detected by histological examinations of biopsy specimens. Polymerase chain reaction (PCR) amplification of the bacterial 16S ribosomal RNA showed the organisms to be Brachyspira pilosicoli.