Index
It is an endoscopic procedure in which a long, thin, flexible tube or “endoscope” is placed in the mouth and advanced into the jejunum (the second portion of the small intestine).
The endoscope is equipped with a light source and a camera at the end that allows the lining of the esophagus, stomach, and small intestine to be examined.
An enteroscopy may be done to diagnose the cause of gastrointestinal symptoms, such as abdominal pain , bleeding, or abnormal X-ray results.
Indications
This test is usually done to diagnose diseases of the small intestine and is done when:
- Abnormal X-ray results are seen.
- Tumors are presumed.
- Diarrheal symptoms occur without any cause.
Process
Most patients will be able to eat normally the day before the exam. Patients will be instructed not to ingest anything after midnight, except medications.
It is very important to follow the instructions given by the doctor. There will also be additional instructions regarding your medications.
In most cases, your medications will continue as usual. However, in certain circumstances, especially in patients taking anticoagulants such as: Coumadin, Warfarin , Plavix, aspirin, and anti-inflammatories.
In the case of diabetics, special instructions will be given.
Heart rate, blood pressure, pulse, respiration, oxygen level, and heart should be monitored through an electrocardiogram, during and after the exam.
The patient must lie down to initiate intravenous sedation.
The sedative is administered in small amounts, once the proper level of sedation is reached, the endoscope is inserted into the mouth.
The scope will be carefully advanced through the esophagus, stomach, and small intestine.
Once the endoscope is inserted into the gastrointestinal tract and depending on the findings of the study, biopsies, removal of polyps and control of bleeding can be performed.
The exam can last 15 to 45 minutes.
Most patients are able to eat and drink normally after discharge from the endoscopy unit, however, specific instructions on activity, diet, and medications will be given to the patient prior to discharge.
Risks of enteroscopy
In general, enteroscopy is a very safe procedure.
Complications are generally not life threatening, but a complication could occur that may require hospitalization and even surgery.
Reactions associated with sedation such as allergic reactions, shortness of breath, cardiac effects, and blood pressure can also occur.
Bleeding can occur when biopsies are performed, polyps are removed, and due to dilation of the stricture.
A rare complication is perforation of the esophagus, stomach, or small intestine.
It is important that the patient see a doctor immediately if symptoms are observed after the procedure, such as abdominal pain, bleeding or fever.
There is a possibility that some abnormalities, including cancer, may not be detected at the time of the exam.
It is important to inform the doctor about the persistence of any symptoms or the appearance of a new symptom.
Alternatives
Alternatives to enteroscopy depend on the reason for the exam.
Enteroscopy is generally one of the best methods for diagnosing and treating diseases in the upper gastrointestinal system, especially when the small intestine is involved.
The upper gastrointestinal tract radiography or upper GI is a procedure that serves to evaluate the upper gastrointestinal tract, but usually requires an enteroscopy later for its treatment.
Abnormal results
When the study reveals no sources of bleeding in the small intestine and no tumor or other abnormal tissue is seen, the results are considered normal.
But if, on the contrary, there are abnormal results, the signs may include:
- Abnormalities of the tissue that lines the small intestine (mucosa) or small finger-like projections on the surface of the small intestine (villi).
- Abnormal lengthening of blood vessels (angiectasia) in the intestinal lining.
- Immune cells called PAS-positive macrophages.
- Polyps, tumors, or cancerous tissue.
- Radiation enteritis.
- Swollen lymph nodes.
- Ulcers.
Changes found on enteroscopy can be signs of disorders and conditions, including:
- Amylose.
- Celiac disease.
- Crohn’s disease .
- Vitamin B12 deficiency.
- Giardiasis.
- Angiectasia of the small intestine.
- Tropical sprue.
- Whipple’s disease.
