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Enteroscopy

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

  • Alternative Names
    • Small bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy; Sonde enteroscopy

  • 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
  • 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:

  • 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.