Enteroscopy

Enteroscopy is a medical procedure that allows physicians to inspect and diagnose issues within the intestine. It involves the use of an instrument known as an endoscope, a flexible tube with a light and camera attached to it, to visualize the interior surfaces of the gastrointestinal tract. This procedure is particularly useful for examining the small intestine, a region that is difficult to reach with more traditional endoscopic techniques such as gastroscopy and colonoscopy.

Types of Enteroscopy

There are several types of enteroscopy, each with its specific applications and techniques. These include:

• Capsule Endoscopy: Involves swallowing a small, pill-sized camera that takes thousands of pictures as it passes through the digestive tract.
• Double-Balloon Enteroscopy (DBE): Utilizes a specialized endoscope fitted with two balloons that can be inflated and deflated to move the endoscope through the small intestine.
• Single-Balloon Enteroscopy (SBE): Similar to DBE but uses only one balloon.
• Spiral Enteroscopy: Uses a spiral-shaped overtube attached to the endoscope to pleat the small intestine onto the overtube as it rotates, allowing deeper insertion into the small intestine.

Indications

Enteroscopy is indicated for various conditions, including but not limited to:

• Unexplained gastrointestinal bleeding
• Iron deficiency anemia of unknown origin
• Suspected small bowel tumors
• Evaluation of inflammatory bowel disease (IBD), such as Crohn's disease
• Polyp surveillance in patients with hereditary polyposis syndromes
• Removal of foreign bodies
• Diagnosis and management of small bowel obstruction

Procedure

The specific procedure for enteroscopy varies depending on the type of enteroscopy being performed. Generally, the patient is sedated to ensure comfort during the procedure. For capsule endoscopy, the patient swallows the capsule with water, and it naturally passes through the digestive system. For balloon-assisted enteroscopy and spiral enteroscopy, the endoscope is inserted through the mouth or the anus, depending on the area of the small intestine that needs to be examined.

Risks and Complications

While enteroscopy is generally safe, there are potential risks and complications associated with the procedure, including:

• Perforation of the intestine
• Bleeding, especially if a biopsy is taken or a polyp is removed
• Infection
• Pancreatitis, particularly associated with procedures involving the duodenum
• Adverse reactions to sedation

Recovery

Recovery from an enteroscopy typically involves a short period of observation to ensure that the patient recovers fully from the sedation and to monitor for any immediate complications. Patients are usually advised to avoid driving and operating heavy machinery for 24 hours following sedation. The results from the enteroscopy can take several days to be finalized, especially if biopsies were taken.

Conclusion

Enteroscopy is a valuable diagnostic and therapeutic tool in the management of various small intestine disorders. Advances in enteroscopic techniques continue to improve the safety, efficacy, and reach of these procedures, allowing for more accurate diagnosis and treatment of small bowel diseases.