When gastroenterologists discover an issue in the small intestine, an option is to perform an enteroscopy to get a better look at the problem area.
Enteroscopy is a procedure gastroenterologists use to examine and treat issues in the small intestine, which is over 20 feet long but only 1 inch wide. Since it's difficult to access this body part, doctors may utilize different techniques depending on what they hope to achieve.
Types of Enteroscopy
Double Balloon Enteroscopy
Double balloon enteroscopy, sometimes called push-and-pull or balloon-assisted enteroscopy, is a minimally invasive surgical technique used to detect and cure issues in the small intestine. An endoscope is a tube with an internal camera. A gastroenterologist will guide the flexible tube into the small intestine.
The doctor can carefully gather the small intestine onto the outer tube by inflating and deflating the balloon on one end of each tube, section by section--similar to how you would gather a curtain onto a curtain rod or push a sleeve up your arm.
The small intestine can be compacted to make it easier for an inner endoscopy tube to reach the entire small bowel length and fix any issues. A gastroenterologist usually introduces the double balloon device through either the mouth (antegrade approach) or colon (retrograde approach).
Enteroscopy (Single Balloon)
A single-balloon enteroscopy, a simplified version of the two-balloon treatment, uses one instead of two balloons. Both procedures are regarded as entirely safe and efficient in the diagnosis and treatment of minor bowel issues.
Enteroscopy (Motorized Spiral)
The endoscope is inserted via a large tube with a rotating spiral, allowing the scope to move from side to side in the small intestine as the spiral turns. A tiny motor is linked to the spiral so the doctor can activate it when needed.
Spiral enteroscopy is a procedure similar to balloon enteroscopy, but instead of using balloons, it uses the spiral technique to help advance the scope. This allows doctors to go deeper into the small bowel than balloon enteroscopy. However, the FDA has not approved this method for use in America.
Endoscopy (Video Capsule)
The small intestine can be examined after the patient swallows a pill-shaped capsule with a camera that takes pictures as it journeys through the digestive tract. This procedure, called capsule endoscopy, can provide doctors with information about the entire small bowel length.
When is an enteroscopy necessary?
The small bowel examination can help doctors see and treat the entire length of the small intestine. The procedure might be recommended if:
- Polyps in the small intestine can be safely and effectively removed with a new medical procedure.
- Areas of bleeding in the small intestine.
- Remove a stricture (intestinal narrowing) by stretching or widening it.
- Collect a foreign item stuck in the intestine.
- Remove a stone from a bile duct when the normal anatomy has been altered, such as after gastric bypass surgery.
- Collect a small intestine tissue sample for microscopic examination (biopsy) for disease indications.
- Widening or holding open a section of the small intestine, placing a stent (a hollow cylinder).
Using a capsule endoscope or imaging scans, a better look may be obtained by combining intravaginal ultrasound (IVU) with enteroscopy.
You'll almost certainly be in the hospital for a night if you need to have an endoscopy, it depends on the specifics of the operation. However, in many circumstances, an endoscopy can be done as an outpatient procedure.
Preparation for a deep enteroscopy varies based on the kind of enteroscopy you are undergoing. Preparation for a deep enteroscopy might include the following:
- Suppose your doctor is using a retrograde approach (accessing the small intestine through the colon) and following a liquid diet. The expedient course would be to take a laxative or enema to cleanse your bowel.
- If your doctor uses an antegrade approach (inserting the endoscopy tubes through the mouth), you may not consume food or liquid for 12 hours before the treatment.
- Before an enteroscopy, tell your doctor about all of your prescription drugs and any allergies you have.
- Someone will need to be arranged to drive you to the treatment center and pick you up after discharge since sedating medications will be unsafe for you to go or use public transportation.
What to expect when you get an Enteroscopy
Your gastroenterologist will do the following things during a balloon or spiral enteroscopy:
- An IV will be used in your arm and give you either a sedative or anesthetic to make you comfortable, calm, or utterly asleep throughout the operation.
- Insert the endoscope through the mouth or anus, then insert it into the duodenum with a balloon or spiral device.
- Inflate and deflate the balloon(s) at the end of the scope, or engage the motorized spiral to gather walls of the intestine and move to an area of concern.
- To look inside the tiny intestine and diagnose and treat issues, use X-ray guidance or fluoroscopy to examine it.
- You can use a few tools to treat the small bowel's deep part that is now accessible. These include forceps, dilation devices, or cauterizing (heat conduction) probes.
Capsule endoscopy is a unique procedure that requires special preparation. Learn more about what you need to do to prepare for your capsule endoscopy.
A local anesthetic will be given or a sedative to help you relax before the surgery. After the procedure, rest and recovery are provided while the effects of the narcotic or anesthesia wear off. Before you go, the doctor will discuss your results with you.
GI Associates & Endoscopy Center offers endoscopy and other exploratory methods to help get you the proper diagnosis and treatment you need for gut health. Please don't hesitate to talk to our team and schedule an appointment today.