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Small Bowel Biopsy
Definition
Enteroscopy is a procedure used to examine the small intestine (small bowel).
Alternative Names
Small bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy; Sonde enteroscopy
How the test is performed
A thin, flexible tube (endoscope) is inserted through the mouth or nose and into the upper gastrointestinal tract. During a double-balloon enteroscopy, balloons attached to the endoscope can be inflated to allow the doctor to view the entire small bowel.
In a colonoscopy, a flexible tube is inserted through your rectum, through the colon, and into the end part of the small intestine.
Tissue samples removed during enteroscopy are sent to the laboratory for examination.
How to prepare for the test
Do not take products containing aspirin for one week before the procedure. If you take blood thinners such as coumadin (Warfarin), ask your doctor about stopping them, as well.
Do not eat any solid foods or milk products after midnight the day of your procedure. You may have clear liquids until 4 hours before your exam. You must sign a consent form.
For infants and children, the preparation you can provide for this test depends on your child's age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:
How the test will feel
When the tube is put into your mouth and down your food pipe, you may feel like gagging. You will get a numbing medicine to reduce this feeling.
You may get a mild sedative, but only in small doses because you must stay alert enough to help with the procedure (by doing such things as swallowing and turning). The biopsy sampling causes little or no pain, although you may have some mild cramping.
Why the test is performed
This test is most often performed to help diagnose diseases of the small intestines. It may be done if you have:
- Abnormal x-ray results
- Tumors in the small intestines
- Unexplained diarrhea
- Unexplained gastrointestinal bleeding
Normal Values
In a normal test result, the health care provider will not find sources of bleeding in the small bowel, and will not find any tumors or other abnormal tissue.
What abnormal results mean
Abnormal findings may include:
- Abnormalities of the tissue lining the small intestine (mucosa) or the tiny, finger-like projections on the surface of the small intestine (villi)
- Immune cells called PAS positive macrophages
-
Polyps
- Radiation enteritis
- Swollen or enlarged lymph nodes or lymphatic vessels
- Ulcers
Changes found on enteroscopy may be signs of disorders and conditions including:
- Amyloidosis
- Celiac sprue
- Coccidiosis
- Crohn's disease
- Folate or Vitamin B12 deficiency
- Giardiasis
- Infectious gastroenteritis
- Lymphangiectasia
- Lymphoma
- Malnutrition
- Tropical sprue
- Whipple's disease
The test may also be performed for lactose intolerance.
What the risks are
Complications are rare but may include:
- Excessive bleeding from the biopsy site
- Hole in the bowel (bowel perforation)
- Infection of the biopsy site leading to bacteremia
- Vomiting, followed by aspiration into the lungs
Special considerations
Factors that prohibit use of this test may include:
- Uncooperative or confused patients
- Untreated blood clotting (coagulation) disorders
- Use of aspirin or other medicines that prevent the blood from clotting normally (anticoagulants)
The greatest risk is bleeding. Signs include:
- Abdominal pain
- Blood in the stools
- Vomiting blood
References
Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut. 2008;57:125-136.
Review Date: 2/29/2008
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright ©2003 A.D.A.M., Inc., as modified by University of California San Francisco. Any duplication or distribution of the information contained herein is strictly prohibited.
Information developed by A.D.A.M., Inc. regarding tests and test results may not directly correspond with information provided by UCSF Medical Center. Please discuss with your doctor any questions or concerns you may have.
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