Health Encyclopedia

Enteroscopy

Definition

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

Alternative Names

Push enteroscopy; Double-balloon enteroscopy; Capsule 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). Capsule endoscopy is done with a disposable capsule that you swallow.

Tissue samples removed during enteroscopy are sent to the lab for examination. (Biopsies cannot be taken with a capsule endoscopy.)

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), clopidogrel (Plavix), or apixaban (Eliquis) 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 and sedating 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.

A capsule endoscopy causes no discomfort.

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 (angioectasis) 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
Small intestinal cancer
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
The capsule endoscope can cause a blockage in a narrowed intestine with symptoms of abdominal pain and bloating

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

Marcinkowski P, Fichera A. Management of lower gastrointestinal bleeding. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:341-347.

Rojas I, Barth B. Capsule endoscopy and small bowel enteroscopy. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 63.

Sugumar A, Vargo JJ. Preparation for and complications of gastrointestinal endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier ; 2021:chap 42.

Waterman M, Zurad EG, Gralnek IM. Video capsule endoscopy. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 93.

Review Date:10/27/2021
Reviewed By:Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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