Inflammations, tumours and haemorrhaging in the small intestine are examined with an endoscopy of the small intestine, also known as an enteroscopy. The entire small intestine is approx. 4 metres long. A full enteroscopy is therefore only possible if is performed from above and from below. A capsule endoscopy is a special form of this method in which a camera capsule is swallowed.
An enteroscopy is used to evaluate diseases of the small intestine. As the small intestine is approx. 4 m long, it cannot be completely recorded with a gastroscopy or with a colonoscopy. Depending on in which part of the small intestine the disease is located, the enteroscopy is either carried out either from above (upper enteroscopy) or below (lower enteroscopy). A combination of both procedures is also required sometimes. A capsule endoscopy can be used instead of an enteroscopy with an endoscope. It is a procedure in which the patient swallows a capsule that contains a camera.
What preparations are carried out before the procedure?
An upper enteroscopy is usually performed under anaesthetic. Patients should therefore have an empty stomach for an enteroscopy. The colon must be cleansed with laxatives before undergoing a lower enteroscopy. A sedative will be administered, along with an infusion in the arm before the procedure.
All blood-thinning medication must be discontinued before the examination takes place.
How is the examination carried out?
Enteroscopy is usually performed on an outpatient basis. During an enteroscopy, a long, thin, flexible tube (endoscope) with a camera mounted on its tip is inserted into the small intestine. The tube also has a working channel over which the surgical instruments can be inserted. The instruments are used to remove tissue samples, to stop bleeding or to remove polyps in the small intestine.
During an upper enteroscopy, an endoscope is fed into the mouth, the oesophagus and the stomach into the small intestine. The endoscope is inserted into the small intestine with the help of fluoroscope imaging and special techniques (double balloon, mono balloon, spiral technique). The upper two metres of the small intestine can be examined with an upper enteroscopy. An upper enteroscopy must be combined with a lower enteroscopy to examine the entire small intestine. If both examinations are necessary, they are usually performed on two consecutive days.
During a lower enteroscopy, an endoscope is fed through the anus and the colon into the small intestine. The two lower metres of the small intestine can be examined with this examination. The examination takes place in the small intestine at the same time as the upper enteroscopy. The examination takes between one and two hours.
A capsule endoscopy is an alternative to an enteroscopy with an endoscope. This method involves swallowing a capsule similar to a medication capsule. The capsule contains a camera which takes video images of the bowel while it is passing through it and sent them a data storage device which is fixed on a belt. After swallowing the capsule, sensors are stuck to the patient's stomach which receive video signals and send them to the aforementioned data storage device. You can carry out your normal daily activities while the data is being recorded. After eight hours, the sensors are removed and the data storage device is removed. The video images are transmitted to a computer and evaluated. The capsule will be passed in the patient's stool one to three days after the surgery.
A capsulendoscopy is used to look for sources of bleeding, polyps or tumours in the small intestine and to clarify whether the patient has Morbus Crohn disease.
What is the success rate of this examination?
Changes in the mucous membrane of the small intestine can be evaluated with an enteroscopy. Tissue samples will be taken from suspicious changes and then analysed afterwards. Smaller polyps in the small intestine can also be removed while the examination is taking place.
What are the possible complications and risks of this examination?
An enteroscopy is a low-risk examination. In rare cases, minor mucous membrane haemorrhaging, stomach pain, vomiting or neck pain can occur. Serious complications such as injury to the intestinal wall or major haemorrhaging are rare.
What happens after the examination?
After the examination you will be monitored until you are fully awake. In the first few hours, the increased amount of air in the colon can cause a feeling of pressure in the stomach. The preliminary examination results will be discussed with you. If tissue samples have been taken, it can take a few days until the final examination results are available. You can usually go home after a few hours. You may not drive a vehicle for 12 hours due to the anaesthetic or the sedative.