Enteroscopy

Enteroscopy is a procedure to examine the small intestine. Using a special endoscope called enteroscope, the lining of the small intestine can be examined visually with the option of taking tissue samples, if necessary. However, the small intestine is 4-6 meters long. There are at least three different ways how to examine the small intestine. The selection of different technique is based on the patient’s condition.

Different Types of Enteroscopy

1. Push Enteroscopy
Push enteroscopy is examination of a short segment of the first part of small bowel called jejunum using a paediatric colonoscope. Due to the length of the small bowel, push enteroscopy is not effective to adequately visualize the entire small intestine. This technique is used for detection and treatment of any lesion or disease localize in the first segment of small intestine, like ulcer, polyp, enlarged vessel called vascular ectasia or angiodysplasia or arterio-venous malformation.

2. Single-balloon or Double-balloon Enteroscopy
Newer techniques, including single and double-balloon enteroscopy enable to examine the entire small bowel using a special enteroscope. This procedure is done under deep sedation and requires time to complete the entire examination of the small bowel.

3. Capsule Endoscopy 
Wireless capsule endoscopy is the non-invasive examination of the entire small bowel. An 11 x 26 mm pill sized video camera is swallowed by the patient and approximately 8 hours of video is transmitted wirelessly to a receiver worn by the patient. The procedure is painless and offers a high accuracy. The limitation of this procedure is the inability to obtain biopsy specimens and provide any endoscopic treatment. Therefore this method is considered a purely diagnostic tool. Another limitation of this technique is the possibility of capsule retention in the small bowel if there is any narrowing or stricture.

How to Prepare for Enteroscopy

Enteroscopy is done on empty stomach, therefore you are asked to not to eat or drink at least 6 hours before the procedure. Before the single and double-balloon enteroscopy , bowel cleansing is required to clear out the content of the small intestine.

If you take a regular medication, inform the doctor before the procedure. Some medications, like blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix), may cause a bleeding. Do NOT stop taking any medication unless told to do so by your doctor.

How Does the Enteroscopy Feel

Just before the enteroscopy you will be given a medicine to help you relax and fall asleep. This is called sedation. With sedation, you should have little, if any, discomfort.

Why Endoscopy is Performed

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

  • Abnormal x-ray or CT scan results
  • Tumor in the small intestines
  • Unexplained gastrointestinal bleeding
  • Unexplained diarrhea
  • Unexplained iron deficiency anaemia
Risks

The major risks are pain or bleeding when the polyp is removed during enteroscopy. There is also a small risk of perforation (tearing) of the tissue wall during endoscopy. For capsule endoscopy there is a risk of capsule retention if the small intestine is narrowed or if there is a small bowel stricture.

Reactions to the sedation may occur, although they are rare. For this reason your breathing, blood pressure, heart rate, and oxygen level will be monitored during the procedure.