Enteroscopy

Enteroscopy is a specialized endoscopic procedure used to examine the small intestine. It involves the use of a longer endoscope that allows for visualization of the jejunum and ileum, which are parts of the small intestine that are typically not accessible with standard upper gastrointestinal (GI) endoscopy or colonoscopy.

Indications for Enteroscopy:

  • Evaluation of GI symptoms: Such as unexplained abdominal pain, gastrointestinal bleeding, or chronic diarrhea.
  • Diagnosis of conditions: Including Crohn’s disease, small bowel tumors, or polyps.
  • Treatment: Can be used to treat bleeding lesions, remove polyps, or perform biopsies.

Types of Enteroscopy:

  1. Push Enteroscopy: A traditional approach where the endoscope is advanced through the mouth or rectum into the small intestine to visualize the upper or lower portions.
  2. Balloon-Assisted Enteroscopy: Involves the use of a specialized balloon to facilitate deeper access into the small intestine. It can be done via:
    • Anterograde (from the mouth): The endoscope is advanced from the oral cavity into the small intestine.
    • Retrograde (from the rectum): The endoscope is introduced through the rectum to visualize the distal portions of the small intestine.

The Procedure:

  1. Preparation: Patients typically need to follow specific dietary restrictions and may require bowel cleansing before the procedure.
  2. Sedation: Most patients receive sedation or anesthesia for comfort during the procedure.
  3. Insertion of Endoscope: The longer endoscope is inserted either through the mouth or rectum, depending on the approach.
  4. Visualization: The endoscope allows for direct visualization of the small intestine’s lining and surrounding structures.
  5. Interventions: If needed, the physician can perform:
    • Biopsy: Taking tissue samples for further analysis.
    • Polypectomy: Removing polyps or abnormal growths.
    • Thermal coagulation: To treat bleeding lesions.

Risks and Complications:

  • Bleeding: Possible, particularly if biopsies or polypectomies are performed.
  • Perforation: A rare but serious risk where the endoscope may create a hole in the intestinal wall.
  • Infection: While uncommon, it is a potential risk.
  • Adverse reactions: To sedation or anesthesia.

Aftercare:

  • Patients are monitored for a short period after the procedure until the effects of sedation wear off.
  • They may experience mild discomfort or bloating, which typically resolves quickly.
  • Specific instructions regarding diet and activity will be provided, especially if biopsies were taken.

When to Seek Medical Attention:

  • Severe abdominal pain or bloating.
  • Signs of infection (fever, chills).
  • Persistent bleeding or changes in bowel habits.