What is Small Bowel Enteroscopy?
Small bowel enteroscopy is a procedure that uses an endoscope to examine the stomach and small intestine (small bowel). An endoscope is a long, thin, flexible tube with a tiny video camera and light at the end. Images from the camera are transmitted to a large monitor for your physician to view the inside of your small bowel. If abnormalities are noted within this region, the endoscope (enteroscope) has working channels through which miniature surgical instruments can be introduced so that diagnostic and therapeutic procedures such as biopsy and electrocautery can be performed.
The small bowel is a long tubular organ that connects the stomach and the large bowel (large intestine or colon). It extends from the stomach (pylorus) to the cecum (beginning of the colon) and consists of three sections: duodenum (first portion of the small bowel), jejunum (middle portion of the small bowel), and ileum (final portion of the small bowel). The main functions of the small bowel are digestion and absorption of ingested food. Small bowel enteroscopy helps to view the first few feet of the small bowel - the duodenum and first part of the jejunum.
Indications for Small Bowel Enteroscopy
Small bowel enteroscopy is indicated for the diagnosis and treatment of various conditions of the upper gastrointestinal (GI) tract (the mouth, oesophagus, stomach, and duodenum). Your physician may recommend small bowel enteroscopy if you have any of the following:
- Intestinal obstruction
- Tumours in the small bowel
- Gastrointestinal bleeding
- Unexplained malnutrition
- Unexplained severe diarrhoea
- Intestinal damage
- Abnormal imaging results
- Elevated white blood cell count
- Severe abdominal pain
Preparation for Small Bowel Enteroscopy
In general, preoperative preparation for small bowel enteroscopy may involve the following:
- Preoperative workup, such as medical evaluation, imaging, and blood work may be done.
- If you are on any medicines such as blood thinners or any supplements, they may need to be stopped at least a week prior to the procedure.
- You need to inform your doctor if you are allergic to specific medications or have any medical conditions that could compromise the safety of the procedure.
- You may take a shower the night prior to or the morning of the procedure.
- You should refrain from food or drink at least 6 hours prior to the procedure.
- Arrange for someone to drive you home, as you may feel groggy due to sedation.
- Your surgeon will thoroughly explain the procedure in detail and obtain your written consent.
Procedure for Small Bowel Enteroscopy
Small bowel enteroscopy procedure usually takes about an hour and may generally involve the following steps:
- You will be asked to lie down on the operating table.
- An intravenous line is placed in your arm for the administration of sedation medication, which keeps you relaxed and sleepy.
- You may also need general anaesthesia if your doctor feels the exam needs deeper sedation.
- Once you are sedated, your physician will carefully introduce an endoscope (enteroscope) through the mouth and slowly advance it through the stomach, duodenum, and into the jejunum by a gentle pushing action.
- If the enteroscope shows any growths or abnormalities in the small bowel, your physician will pass tiny instruments through the enteroscope to take biopsies (small tissue samples taken for further examination), remove abnormal growths (polyps), or cauterise lesions (abnormalities) that may be the cause of bleeding.
Postoperative Care and Recovery
Post-procedure care and instructions may involve the following:
- You will be transferred to the recovery area where you will be asleep until the sedation or anaesthesia wears off.
- Your nurse will monitor your blood oxygen level and other vital signs as you recover in the recovery area.
- It is normal for you to feel soreness in the throat due to the tube used as well as pain or discomfort in the abdominal area once you gain consciousness.
- You will be given pain medicines and anti-nausea medications to relieve your discomfort.
- Diet and/or medication restrictions may be advised to certain individuals depending on the findings of the exam and the procedure performed.
- You will be discharged home after 30 to 60 minutes of observation. You should be able to resume your normal diet once you return home.
- You should be able to return to your normal daily routines the next day, unless your physician gives you other instructions.
Risk and Complications
Small bowel enteroscopy is a relatively safe procedure; however, as with any procedure some risks and complications may occur such as:
- Adverse reaction to anaesthesia/sedation
- Internal bleeding
- Bowel wall tear or perforation
- Abdominal bloating
- Throat soreness
- Mild cramps
- Upper GI Endoscopy
- Colon Cancer Screening
- Capsule Endoscopy
- Endoscopic Ultrasound (EUS)
- Endoscopic Retrograde Cholangiopancreatography (ERCP)
- Endoanal & Endorectal Ultrasound
- Diagnostic Tests for Gastrointestinal Disorders
- Bravo pH Study
- Small Bowel Enteroscopy
- STRETTA Treatment for Acid Reflux or GERD
- Oesophageal Dilation
- Dilatation of Oesophageal Strictures
- Radiofrequency Ablation & Endoscopic Eradication Methods for Barrett's Esophagus
- Orbera Managed Weight Loss System
- Gastrointestinal Stent
- Insertion of Oesophageal Stents
- Feeding Tube
- PEG Tube Insertion & Management
- Endoscopic Mucosal Resection (EMR) of Polyps
- Endoscopic Mucosal Resection EMR
- Endoscopic Submucosal Dissection
- Hemorrhoidal Band Ligation