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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 usually 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 large part of the small intestine.

    In a colonoscopy, a flexible tube is inserted through your rectum and colon. The tube usually can reach into the end part of the small intestine (ileum). See also: Colonoscopy

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

    How to Prepare for the Test

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

    When the tube is put into your mouth and down your esophagus (food pipe), you may feel like gagging. You will get a numbing medicine to reduce this feeling.

    You may get a mild sedative, but only in small doses because you must stay alert enough to help with the procedure (by doing such things as swallowing and turning). The biopsy sampling causes little or no pain, although you may have some mild cramping.

    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 health care 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 ofblood 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's disease
    • Folate or vitamin B12 deficiency
    • Giardiasis
    • Infectious gastroenteritis
    • Lymphangiectasia
    • Lymphoma
    • Small intestinal angiectasia
    • Tropical sprue
    • Whipple's 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 patients
    • 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

    References

    Jensen DM. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Schafer AI, eds. Cecil Medicine.24thed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 137.

    Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut. 2008;57:125-136.

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    • Small intestine biopsy

      illustration

      • Small intestine biopsy

        illustration

      Tests for Enteroscopy

      Review Date: 2/19/2012

      Reviewed By: David C. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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