Small Intestine Enteroscopy

If you’re experiencing stomach or intestinal problems, your health care provider may suggest an enteroscopy. An enteroscopy is one of many endoscopy procedures used to view the inside of the human body.

Read on to understand why you might need an enteroscopy, how to prepare and what to expect during and after the procedure. 

What is enteroscopy?

Enteroscopy is a medical procedure used to look at the small intestine (small bowel), a part of the gastrointestinal (GI) tract. The small intestine stretches from the stomach to the large intestine (colon) and digests and absorbs nutrients from the food you eat. It is over 20 feet long and just 1 inch wide, which makes it difficult to access.

Gastroenterologists perform enteroscopies to diagnose and treat gastrointestinal issues without cutting into your belly (abdomen). Gastroenterologists pass a long, flexible tube fitted with a light and tiny camera, called an endoscope, through your mouth and throat (upper enteroscopy) or anus and rectum (lower enteroscopy) to reach the small intestine.

Sometimes, small instruments can be passed through the tube to take a small piece of tissue or a cell sample (a biopsy) to confirm a diagnosis. Tools can also be used to repair or treat conditions.

Why might I need an enteroscopy?

Your provider may recommend an enteroscopy to:

• Investigate symptoms: If you have ongoing issues like belly pain, abnormal bleeding, trouble eating or unexpected weight loss, enteroscopy can help determine what’s causing them. It’s also useful for problems like long-lasting nausea, vomiting and diarrhea.
• Diagnose a condition: Enteroscopies help diagnose conditions like Crohn’s disease, ulcerative colitis and tumors. They can also spot swelling (inflammation) or abnormal growths in the small intestine.
• Treat a condition: An enteroscope can not only find problems, but it can also fix many of them. Your provider can use special tools attached to the enteroscope to remove abnormal growths (polyps), stop bleeding or open up blocked areas in your small intestine.

Types of enteroscopy

There are several different types of enteroscopy and they each have their benefits depending on what your provider needs to see:

Single balloon enteroscopy (SBE)

This procedure uses a flexible tube with a small balloon at the tip. SBE can be performed via upper endoscopy or lower enteroscopy. The balloon helps the tube move into the intestine, while a camera on the tube allows your provider to see inside the small intestine. If any issues are found, your provider can use tiny instruments passed through the tube to take samples, remove growths or perform other treatments. 

Double balloon enteroscopy (DBE)

Sometimes called a push-and-pull or balloon-assisted enteroscopy, DBE is similar to SBE but uses two balloons instead of one, giving it a greater reach into the small intestine. 

A DBE uses a long endoscope with a balloon on the end that is fitted into a long overtube with a second balloon on the tip. The balloons are alternately inflated and deflated, which helps the tube advance deeper into the small intestine. The process pleats the small bowel over the overtube, like a curtain being pushed over a rod.

As the tube advances, the camera sends images to a screen. If any issues are found, your provider can perform treatments such as taking samples or removing growths using special tools passed through the tube.

Spiral enteroscopy

Spiral enteroscopy is a newer technique involving a tube with a rotating spiral placed over the endoscope allowing it to move back and forth during the procedure to capture video images of the small intestine. Spiral enteroscopy (like balloon enteroscopy) can go deeper into the small intestine. The spiral is moved by hand and is a two-person procedure.

Motorized spiral enteroscopy includes a small motor attached to the spiral tube to help advance the tube through the small intestine. However, the U.S. Food and Drug Administration (FDA) has not approved motorized spiral enteroscopy in the United States. 

Possible risks of an enteroscopy

Enteroscopies are very safe procedures. But like other endoscopies, they carry potential risks. These risks, though rare, include:

• Bleeding after a biopsy or treating a problem
• Reaction to the medication (sedative) that helps you relax and feel sleepy 
• A small tear or hole (perforation) in the wall of your throat, stomach or small intestine
• Pancreatitis 
• Infection if the equipment is not properly cleaned and sterilized

It’s important to talk to your provider if you have any worries or questions about getting an enteroscopy. They’ll help you understand everything and ensure your safety during the procedure.

How to prepare for an enteroscopy

Your provider will give you specific instructions on how to prepare for an enteroscopy, but generally you’ll need to:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider questions if anything is unclear.
• Fast: You should avoid eating and drinking, including water, for at least six to eight hours before the procedure to ensure your stomach is empty.
• Adjust medications: Your provider may ask you to temporarily stop certain medications, especially blood thinners, to reduce the risk of bleeding during the procedure. Do not take any antacids, aspirin or ibuprofen. If you have ongoing conditions such as diabetes or heart disease, your provider will give you specific instructions about your medications.
• Make arrangements: Since you will take medicine to relax you (a sedative), you will need to have someone drive you home after the exam. Sedatives can affect your judgment and reflexes for the rest of the day, so do not operate machinery or make any important decisions.

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant.

What to expect during an enteroscopy

A balloon or spiral enteroscopy can be performed as an outpatient procedure or as part of a hospital stay. The way the test is performed may vary depending on your condition and your provider’s practices. 

In general, it follows this process:

• You will change into a gown and remove any jewelry or accessories. This ensures that you are comfortable during the procedure and allows your provider easy access to the area being looked at.
• An intravenous (IV) line will be started in your arm or hand. You will be given medicine (a sedative) through the IV to help you relax and feel sleepy. If you have an upper enteroscope, a local anesthetic will be sprayed into your mouth and throat to numb the area.
• During the procedure, trained medical professionals will closely monitor your vital signs, such as heart rate, blood pressure and oxygen levels.
• Once fully sedated, you will lie on your left side and a lubricated endoscope will be inserted through your mouth or anus into the small bowel. You may feel pressure, but you should not feel pain.
• To move the endoscope through the small intestine and reach the problem area, your provider will either inflate and deflate balloons or engage a spiral tool that gently gathers the intestine walls and moves the scope into place. You may feel pressure, but you should not feel pain.
• The camera will send pictures to a screen so your provider can see inside your intestine. Tools may be used to take a sample or make a small repair.
• When the exam is done, the scope will be taken out.

The procedure usually takes between 45 minutes and 2 hours. 

Recovery from an enteroscopy

After the procedure, you’ll be taken to a recovery area where you’ll rest until the effects of the medicine wear off. You may feel a little groggy or sleepy for a short time. Have someone bring you home after the procedure. Do not drive yourself home or return to work for the rest of the day.

Depending on whether you had an upper or lower enteroscopy, you may have a mild sore throat, bloating, gas or mild stomach cramping. These should get better within a day or two. 

Your medical staff will provide you with post-procedure instructions, including any restrictions on eating or drinking, when you can resume taking medications and when to follow up with your provider for the results of the procedure and biopsy, if performed. Your provider may discuss the results of your enteroscopy immediately after the procedure or during another appointment, especially if you had a biopsy. 

Call your provider immediately if you have any of the following:

• Fever and chills
• Belly pain that doesn’t go away
• Coughing, spitting or vomiting blood
• Dark or black stools (poops)
• Feel dizzy or faint
• Have not had a bowel movement for 3 days after your procedure

Call 911 or have someone take you to the nearest emergency department if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

What happens if the results are abnormal?

If your provider finds anything unusual, like inflammation or signs of a condition, they will talk to you about what it means and what to do next. They might suggest additional testing, treatments and follow-up care.

Expert Care

Are you suffering from stomach or intestinal problems? If you are in need of an enteroscopy, Banner Health’s experts are here to help. We offer a comfortable environment and advanced technology for your endoscopy needs.