Small Bowel Biopsy
Enteroscopy is a procedure used to examine the small intestine (small bowel).
Small bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy
How the Test is Performed
A thin, flexible tube (
Tissue samples removed during enteroscopy are sent to the lab for examination. (Biopsies cannot be taken with a capsule endoscopy.)
How to Prepare for the Test
Do not take products containing aspirin for 1 week before the procedure. Tell your health care provider if you take blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix), because these may interfere with the test. Do NOT stop taking any medicine unless told to do so by your provider.
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.
How the Test will Feel
You will be given calming medicine for the procedure and will not feel any discomfort. You may have some bloating or cramping when you wake up. This is from air that is pumped into the abdomen to expand the area during the procedure.
A capsule endoscopy causes no discomfort.
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
In a normal test result, the 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
Signs 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)
- Abnormal lengthening of blood vessels (angiectasis) in the intestinal lining
- Immune cells called PAS-positive macrophages
Polypsor cancer Radiation enteritis
- Swollen or enlarged
lymph nodesor lymphatic vessels
Changes found on enteroscopy may be signs of disorders and conditions, including:
Amyloidosis Celiac sprue Crohn disease Folateor vitamin B12deficiency Giardiasis
gastroenteritis Lymphangiectasia Lymphoma
- Small intestinal angiectasia
- Small intestinal cancer
Tropical sprue Whipple disease
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
- Vomiting, followed by
aspirationinto the lungs
- The capsule endoscope can cause a blockage in a narrowed intestine with symptoms of abdominal pain and bloating
Factors that prohibit use of this test may include:
- Uncooperative or confused person
- 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
Barth B, Troendle D. Capsule endoscopy and small bowel enteroscopy. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 63.
Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 135.
Vargo JJ. Preparation for and complications of GI endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.
Review Date: 26/10/2017
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