Small Bowel Enteroscopy – Diagnosis and Treatment
Small bowel enteroscopy is a minimally invasive test that doctors may use to inspect the walls of the small intestine in detail. This part of the digestive tract, sandwiched between the stomach and large intestine, is not always readily accessible to routine endoscopes. Small bowel enteroscopy is the use of a long, flexible tube with a camera to visualise and, if indicated, treat this region.
This process is essential to diagnosing the cause of unexplained gastrointestinal symptoms such as internal bleeding, long-term abdominal pain, or anaemia. It’s particularly helpful for diagnosing disorders in ailments like Crohn’s disease, small bowel obstruction, and even tumours. One of the most important benefits is that it has the potential to reduce the requirement for invasive small bowel surgery in many of these patients and is favoured by both patients and clinicians.
Understanding the Small Bowel Anatomy and Function
The small bowel (also known as the small intestine) is a long tube which acts as the body’s digestion and nutrient absorption organ. It is approximately 6 metres in length and is divided into three parts: the duodenum, jejunum, and ileum. Whereas the large bowel absorbs water and forms stool, the small bowel digests food and absorbs nutrients into the bloodstream.
Its interior surface is covered with microscopic, finger-like structures called villi, which increase its surface area for absorption. Because of its vital functions, disturbances in small bowel function—whether due to inflammation, infection, or obstruction—can have wide-ranging effects on overall health.
Why is Small Bowel Enteroscopy Performed?
A small bowel enteroscopy is generally used to examine unexplained and persistent gastrointestinal symptoms that may be difficult to diagnose with standard endoscopy or colonoscopy. These include:
- Recurrent or chronic bleeding from the GI tract
- Iron-deficiency anaemia of unknown cause
- Obstruction or suspected impaction of the small intestine
- Abnormal findings from capsule endoscopy or imaging scans
The procedure also has therapeutic potential alongside diagnostic value. For example:
- Polyps can be excised
- Bleeding vessels can be cauterised
- Constricting areas (known as strictures) can be dilated
All of these can be performed using the gastrointestinal endoscope, avoiding the need for open surgery.
Conditions Diagnosed with Small Bowel Enteroscopy
Several significant conditions can be diagnosed with small bowel enteroscopy:
- Small bowel obstruction: Caused by adhesions, hernias, or tumours; symptoms include cramps, vomiting, and bloating.
- Small bowel bacterial overgrowth (SBBO): A condition where excess bacteria in the small intestine leads to bloating, diarrhoea, and malabsorption.
- Crohn’s disease: An inflammatory bowel disease that can cause ulcers, strictures, and chronic inflammation.
- Tumours and vascular malformations: May lead to occult bleeding, anaemia, and melaena.
Early and accurate diagnosis improves treatment success and reduces complications.
How is Small Bowel Enteroscopy Performed?
The procedure involves inserting a flexible endoscope either:
- Through the mouth (anterograde), or
- Through the rectum (retrograde)
This depends on where the issue is suspected. Modern imaging and sometimes balloon-assisted techniques help navigate the small bowel.
During the examination, the doctor may:
- Take biopsies for lab analysis
- Cauterise bleeding lesions
- Remove polyps
- Dilate strictures
Unlike capsule endoscopy (which only captures images), small bowel enteroscopy allows immediate therapeutic intervention, making it a more comprehensive procedure.
Recovery and Aftercare
After the procedure, most patients can go home the same day. Common side effects include:
- Mild bloating or cramping
- A sore throat (if the scope was inserted orally)
Most of the time, these symptoms go away in a day or two. However, patients should call 999 for an ambulance if they experience:
- Severe abdominal pain
- Fever or chills
- Rectal bleeding
A follow-up appointment may be scheduled to discuss biopsy results or further treatment.
When is Small Bowel Blockage Surgery Needed?
Surgery may be unavoidable in cases of complete obstruction. Indications include:
- Severe, persistent vomiting
- Absent bowel sounds
- Signs of infection or peritonitis
However, partial obstructions or minor strictures can often be managed with small bowel enteroscopy, reducing recovery time and surgical risks.
Conclusion
Small bowel enteroscopy has revolutionised the diagnosis and treatment of small intestinal disorders—from detecting occult bleeding to managing Crohn’s disease and SBBO. It offers diagnostic accuracy, therapeutic capability, and a faster recovery compared to surgery.
If you experience chronic abdominal pain, unexplained anaemia, or symptoms of small bowel obstruction, consult a gastroenterologist at Chase Lodge Hospital. Our expert team provides compassionate, cutting-edge care.
Book an appointment today or learn more about small bowel enteroscopy on the NHS website.
