Small bowel enteroscopy is a procedure used to examine the small bowel, the portion of the intestine that lies immediately below the stomach.

What is small bowel enteroscopy?

An enteroscope is a thin, tube, around 2 to 2.5 metres long, with a camera at one end which can relay images or video taken inside the body. It usually has a channel for biopsy tools to allow a range of treatments to be performed through the instrument.

The enteroscope is passed through the throat, oesophagus (the long, muscular tube that connects your stomach and mouth) and stomach and into the duodenum which is the top part of your small intestine. Kinks that formed as it passed through the stomach are then removed, and the instrument is passed down into the small bowel. Images from the examination are studied and any biopsies or treatments are carried out. A small bowel enteroscopy can usually be completed in about 45 minutes and is done under sedation.

Why have a small bowel enteroscopy?

There are three main reasons: for diagnosis, for treatment and for surveillance of rare conditions that lead to polyp formation in the small bowel.

Small bowel enteroscopy and diagnosis

The main reason someone has a small bowel enteroscopy is to investigate otherwise unexplained bleeding in the digestive system.
The procedure can also be used to:

  • Investigate unexplained digestive problems such as malabsorption of nutrients in food.
  • Investigate persistent or frequent diarrhoea that has no obvious cause
  • Look in more detail at any problems detected on a CT or MRI scan
  • Take biopsies of any suspicious lesions

Small bowel enteroscopy and treatment

  • Inserting a feeding tube: the enteroscope can identify locations in the upper small intestine (jejunum) to introduce a feeding tube through for patients who have had surgery to remove the stomach, or who have problems with food passing through their stomach.
  • Thermocoagulation of bleeding: using a special high-frequency electric current to cauterise or burn damaged, fragile or broken blood vessels within the wall of the small bowel which are leaking blood into the digestive system.

Monitoring rare conditions

Patients with rare genetic conditions such as Peutz-Jeghers syndrome or familial adenomatous polyposis are at risk of developing polyps in the small bowel. These can cause blockages, ruptures and bleeding. Enteroscopy done on a regular basis can be done to remove polyps before they too large.