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Enteroscopy

Enteroscopy is a medical procedure that examines the small intestine (small bowel), which is a thin, flexible tube attached to a camera. A physician can perform an enteroscopy using three different techniques:

  • Enteroscopy with a single balloon.

  • Enteroscopy with two balloons.

  • The spiral enteroscopy.

There are two types of enteroscopy: upper and lower. The endoscope is inserted into the mouth during an upper enteroscopy. The endoscope is inserted into the rectum during a lower enteroscopy. Depending on the type of problem the doctor is attempting to diagnose, your doctor will let you know in advance which type of enteroscopy you need.

What Is The Purpose Of This Test?

Tests of this type are usually performed to diagnose diseases of the small intestine. Doctors can examine the lining of the small intestine, without making an incision, to determine whether any diseases are present. The test also allows taking tissue samples (biopsy) for analysis by the pathology department, if necessary.

Tests can be performed if you have:

  • A case of unexplained diarrhoea.

  • Digestive bleeding is not explained.

  • Reports of abnormal barium meal follow-up (BMFT) or CT endocytosis.

  • Small intestine tumours.

Advanced Enteroscopic techniques

Capsule endoscopy:

Capsule endoscopy is a diagnostic Enteroscopic procedure in which a person swallows a small wireless camera hidden inside a capsule the size of a vitamin. As the camera travels through a person’s digestive tract, pictures are taken along the way. Thousands of pictures are transmitted from the ingested camera to the sensors placed on the abdomen and then to a recorder attached to a belt tied around the waist of the person. The capsule with the camera is thrown out of the body with the stool once it passes through the tract. The doctor can then interpret the images and determine the appropriate treatment.

Endoscopy of the capsule is considered to be a safe procedure with very few risks. The capsules can, however, become lodged in the digestive tract rather than pass through the body in a bowel movement. It’s more common in people with conditions like tumours, Crohn’s disease, or narrowing’s (strictures) in the digestive tract due to surgery.

Spiral enteroscopy:

The spiral enteroscopy technique is a simple and faster alternative to other device-assisted Enteroscopic techniques like balloon-assisted enteroscopy. In small bowel procedures, it is a minimally invasive therapeutic technique. The procedure is endoscopic, so the surgical component is omitted. The spiral Enteroscopy is protected by a disposable tube that slides over it. 

Enteroscopes feature a spiral at the tip that can be rotated so that they can be advanced quickly. Spirals allow gentle access to the digestive tract by pledging the small bowel onto an Enteroscopy for examination and, if necessary, treatment of conditions like polyps and bleeding. A spiral Enteroscopy can be either mechanical or motorized. The device is inserted into the small intestine under video and fluoroscopic guidance in a clockwise spiral rotation.

For the diagnosis and treatment of small bowel lesions and pathologies, the spiral enteroscopy technique is considered safe and effective.

How Is The Test Performed?

During an endoscope procedure, a thin, flexible tube is inserted into the upper gastrointestinal tract through the mouth or nose. Enteroscopy with a single balloon allows the doctor to examine the entire small bowel by using an endoscope attached to a balloon. The tissue samples collected during an enteroscopy are sent to the laboratory for examination.

Procedure

You will receive specific preparation instructions prior to your scheduled enteroscopy. You may not be able to pass the test if you do not do the preparation properly.

Depending on the type of enteroscopy you have, you will receive different instructions. Diet and medication restrictions may be part of the instructions, as well as bowel preparation to clear the colon.

Enteroscopy is an outpatient procedure, meaning the person can go home the same day as the procedure. The procedure usually takes 45 minutes to two hours. Depending on the type of enteroscopy, general anaesthesia may be required or sedation may be used during the procedure. Intravenously administered medicines are injected into a vein in the arm.

An Enteroscopy is used to visualize and record images of your intestinal lining during the procedure. A sample of your small bowel lining might need to be taken for analysis during the investigation. The biopsy should not cause discomfort for you.

Enteroscopy is usually performed through the oral route. Nevertheless, if the procedure is incomplete, it can be completed through the retrograde (anal) route. 

Upper Enteroscopy (Antegrade Enteroscopy) 

  • For the smooth start of the procedure, it is advisable to arrive at least 30 minutes before the scheduled appointment time to complete the administrative formalities.  

  • An examination is performed before the procedure to ensure the person is healthy enough to undergo it.

  • Enteroscopy is performed under general anaesthesia or sedation, so an intravenous line is placed. It is also possible to insert an arterial line during the procedure to monitor blood pressure.

  • Monitors are attached to observe the patient’s vital signs throughout.

  • The procedure is performed on the patient’s left side.

  • Following numbing the throat, the gastroenterologist inserts an endoscope into the mouth and guides it through the Esophagus and into the stomach and upper digestive tract.

  • During this stage of the procedure, the person may feel pressure or fullness.

  • In this procedure, the gastroenterologist may take biopsies, i.e. small tissue samples, or remove polyps or cauterize abnormal lesions that may be the source of symptomatic bleeding.

Lower Enteroscopy (Retrograde Enteroscopy)

This procedure involves passing an Enteroscopy fitted with a fibre-optic light and camera through the rectum, along the entire length of the large intestine, and into the small intestine. 

The risks of Enteroscopy

Enteroscopy is a relatively safe procedure when performed by a gastroenterologist with experience, but it is not devoid of risks and side effects. There are few side effects, but they can be mild.

  • Bloating of the abdomen

  • Minor bleeding

  • Nausea

  • Some amount of cramping

  • Sore throat

Enteroscopy procedures rarely result in complications. These include:

  • Internal bleeding

  • Pancreatitis

  • Tearing in the wall of the small intestine

In obese people, pregnant women, or people with chronic diseases of the heart or lungs, enteroscopy is usually avoided or performed with extreme caution due to the risk of adverse reactions to anaesthesia.

After an enteroscopy, the patient should consult a gastroenterologist immediately if they experience:

  • There is more blood in the stool than a few drops

  • Fever

  • Severe pain in the stomach

  • Significant abdominal distension

  • Vomiting

CARE Hospitals offers enteroscopy services in India for the treatment of gastrointestinal bleeding, diarrhoea, and tumours in the small intestine.

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