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Enteroscopy

Small bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy; Sonde enteroscopy

 

Enteroscopy is a procedure used to examine the small intestine (small bowel).

How the Test is Performed

 

A thin, flexible tube ( endoscope ) is inserted through the mouth and into the upper gastrointestinal tract. During a double-balloon enteroscopy, balloons attached to the endoscope can be inflated to allow the doctor to view a section of the small intestine.

In a colonoscopy , a flexible tube is inserted through your rectum and colon. The tube can most often reach into the end part of the small intestine (ileum).

Tissue samples removed during enteroscopy are sent to the lab for examination.

 

How to Prepare for the Test

 

Do not take products containing aspirin for 1 week before the procedure. Tell your health care provider if you take blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix), because these may interfere with the test. Do NOT stop taking any medicine unless told to do so by your provider.

Do not eat any solid foods or milk products after midnight the day of your procedure. You may have clear liquids until 4 hours before your exam.

You must sign a consent form.

 

How the Test will Feel

 

You will be given calming medicine for the procedure and will not feel any discomfort. You may have some bloating or cramping when you wake up. This is from air that is pumped into the abdomen to expand the area during the procedure.

 

Why the Test is Performed

 

This test is most often performed to help diagnose diseases of the small intestines. It may be done if you have:

  • Abnormal x-ray results
  • Tumors in the small intestines
  • Unexplained diarrhea
  • Unexplained gastrointestinal bleeding

 

Normal Results

 

In a normal test result, the provider will not find sources of bleeding in the small bowel, and will not find any tumors or other abnormal tissue.

 

What Abnormal Results Mean

 

Signs may include:

  • Abnormalities of the tissue lining the small intestine (mucosa) or the tiny, finger-like projections on the surface of the small intestine (villi)
  • Abnormal lengthening of blood vessels (angiectasis) in the intestinal lining
  • Immune cells called PAS-positive macrophages
  • Polyps or cancer
  • Radiation enteritis
  • Swollen or enlarged lymph nodes or lymphatic vessels
  • Ulcers

Changes found on enteroscopy may be signs of disorders and conditions, including:

  • Amyloidosis
  • Celiac sprue
  • Crohn disease
  • Folate or vitamin B12 deficiency
  • Giardiasis
  • Infectious gastroenteritis
  • Lymphangiectasia
  • Lymphoma
  • Small intestinal angiectasia
  • Tropical sprue
  • Whipple disease

 

Risks

 

Complications are rare but may include:

  • Excessive bleeding from the biopsy site
  • Hole in the bowel (bowel perforation)
  • Infection of the biopsy site leading to bacteremia
  • Vomiting, followed by aspiration into the lungs

 

Considerations

 

Factors that prohibit use of this test may include:

  • Uncooperative or confused person
  • Untreated blood clotting (coagulation) disorders
  • Use of aspirin or other medicines that prevent the blood from clotting normally (anticoagulants)

The greatest risk is bleeding. Signs include:

  • Abdominal pain
  • Blood in the stools
  • Vomiting blood

 

 

Open References

References

Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 135.

Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut . 2008;57:125-136. PMID: 18094205 www.ncbi.nlm.nih.gov/pubmed/18094205 .

Vargo JJ. Complications of gastrointestinal endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.

 
  • Small intestine biopsy

    Small intestine biopsy - illustration

    Small bowel biopsy is a diagnostic procedure in which a portion of the small bowel lining is removed for examination. A flexible fiberoptic or video tube (endoscope) is inserted through your mouth or nose and into the upper gastrointestinal tract where a tissue sample is removed. This test is most often performed to help diagnose diseases of the small intestines.

    Small intestine biopsy

    illustration

    • Small intestine biopsy

      Small intestine biopsy - illustration

      Small bowel biopsy is a diagnostic procedure in which a portion of the small bowel lining is removed for examination. A flexible fiberoptic or video tube (endoscope) is inserted through your mouth or nose and into the upper gastrointestinal tract where a tissue sample is removed. This test is most often performed to help diagnose diseases of the small intestines.

      Small intestine biopsy

      illustration

    Tests for Enteroscopy

     
     

    Review Date: 10/27/2015

    Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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