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Enteroscopy is a procedure used to examine the small intestine (small bowel).
Alternative NamesSmall bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy; Sonde enteroscopy
How the test is performedA 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 a large part of the small intestine.
In a colonoscopy, a flexible tube is inserted through your rectum and colon. The tube usually can reach into the end part of the small intestine (ileum). See also: Colonoscopy
Tissue samples removed during enteroscopy are sent to the laboratory for examination.
How to prepare for the testDo not take products containing aspirin for 1 week before the procedure. Tell your doctor if you take blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix), because these may interfere with the test. Do NOT stop taking any medication unless told to do so by your health care 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 feelWhen the tube is put into your mouth and down your esophagus (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 performedThis 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 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 meanAbnormal 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 or cancer
- 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
- Crohn's disease
- Folate or vitamin B12deficiency
- Giardiasis
- Infectious gastroenteritis
- Lymphangiectasia
- Lymphoma
- Tropical sprue
- Whipple's 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 bacteremia
- Vomiting, followed by aspiration into the lungs
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:
ReferencesBjorkman DJ. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 137.
Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut. 2008;57:125-136.
Wiki User
∙ 13y ago
Wiki User
∙ 12y agoEnteroscopy is a procedure used to examine the small intestine (small bowel).
Alternative NamesSmall bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy; Sonde enteroscopy
How the test is performedA 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 a large part of the small intestine.
In a colonoscopy, a flexible tube is inserted through your rectum and colon. The tube usually can reach into the end part of the small intestine (ileum). See also: Colonoscopy
Tissue samples removed during enteroscopy are sent to the laboratory for examination.
How to prepare for the testDo not take products containing aspirin for 1 week before the procedure. Tell your doctor if you take blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix), because these may interfere with the test. Do NOT stop taking any medication unless told to do so by your health care 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 feelWhen the tube is put into your mouth and down your esophagus (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 performedThis 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 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 meanAbnormal 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 or cancer
- 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
- Crohn's disease
- Folate or vitamin B12deficiency
- Giardiasis
- Infectious gastroenteritis
- Lymphangiectasia
- Lymphoma
- Tropical sprue
- Whipple's 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 bacteremia
- Vomiting, followed by aspiration into the lungs
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:
ReferencesBjorkman DJ. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 137.
Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut. 2008;57:125-136.
Reviewed ByReview Date: 01/20/2010
David C. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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What is the combining form of enteroscope?
The combining form for otoscope is oto...ear and scope..to examine.
What is CPT code for double balloon enteroscopy?
44799 unlisted procedure intestine for sbe and dbe susna eosso, cpc ,cmrs
Polyp in small intestine It can't be reached to perform biopsy or removal via colonoscopy What are alternative methods to perform biopsy or removal?
a double-balloon enteroscopy...a procedure that specifically examines the small bowel...11 facilities in the U.S. offer this procedure.
Whipple's disease?
DefinitionWhipple's disease is a rare condition that prevents the small intestines from properly absorbing nutrients. This is called malabsorption.Alternative NamesIntestinal lipodystrophyCauses, incidence, and risk factorsWhipple's disease is caused by infection from bacteria called Tropheryma whippelii. The disorder mainly affects middle-aged white men.Whipple's disease is extremely rare. Risk factors are unknown.SymptomsSymptoms usually start slowly. Joint paint is the most common initial symptom. After that, often several years later, symptoms of gastrointestinal (GI) infection develop. Other symptoms may include:Abdominal painDiarrheaFeverGray to brown skin colorJoint painMemory lossMental changesWeight lossSigns and testsPossible signs:Enlarged lymph glandsFatty stoolsGastrointestinal (GI) bleedingHeart murmurSwelling in body tissues (edema)Tests to diagnose Whipple's disease may include:Complete blood count (CBC)Polymerase chain reaction (PCR) testing of the affected tissue for Tropheryma whippeliiSmall bowel biopsyUpper GI endoscopy (viewing the intestines with a flexible, lighted tube in a process called enteroscopy )This disease may also change the results of the following tests:Albumin levels in the bloodUnabsorbed fat in the stools (fecal fat)Intestinal absorption of a type of sugar (d-xylose absorption)TreatmentPeople with Whipple's disease need to take long-term antibiotics to cure any infections of the brain and central nervous system. An antibiotic called ceftriaxone is given through a vein (IV). It is followed by another antibiotic (such as trimethoprim-sulfamethoxazole) taken by mouth for up to 1 year.If symptoms come back during antibiotic use, the antibiotic treatment may be changed.Your health care provider should closely follow your progress, because signs of the disease can return after you finish therapy. Those who have nutritional deficiencies from malabsorption will also need to take dietary supplements.Expectations (prognosis)Without treatment, the condition is usually fatal. Treatment relieves symptoms and can cure the disease.ComplicationsBrain damageHeart valve damage (from endocarditis)Nutritional deficienciesSymptoms return (which may be because of drug resistance)Weight lossCalling your health care providerCall your health care provider if you have persistent joint pain, abdominal pain, or diarrhea.If you are being treated for Whipple's disease, call your health care provider if:Symptoms worsen or do not improveSymptoms reappearNew symptoms developReferencesWest SG. Systemic diseases in which arthritis is a feature. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 297.
Anemia - B12 deficiency?
DefinitionAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.Vitamin B12 deficiency anemia is a low red blood cell count due to a lack of vitamin B12.See also:Megaloblastic anemiaPernicious anemiaAlternative NamesMacrocytic anemiaCauses, incidence, and risk factorsYour body needs vitamin B12 to make red blood cells. In order to provide vitamin B12 to your cells:You must eat enough foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, and dairy products.Your body must absorb enough vitamin B12. Your body uses a special protein, called intrinsic factor, released by cells in the stomach. The combination of vitamin B12 attached to intrinsic factor is absorbed in the last part of the small intestine.A lack of vitamin B12 in the diet may be due to:Eating a vegetarian dietPoor diet in infancyPoor nutrition during pregnancyA number of problems can make it difficult for your body to absorb enough vitamin B12:ChronicalcoholismCrohn's disease, celiac disease, infection with the fish tapeworm, or other problems that make it difficult for your body to digest foodsPernicious anemia, which occurs when your body destroys cells that make intrinsic factor. Intrinsic factor is needed to absorb vitamin B12.Surgeries that remove certain parts of your stomach or small intestine, such as some weight-loss surgeriesTaking antacids and other heartburn medicines for a long period of timeSymptomsPeople with mild anemia may have no symptoms, or symptoms may be very mild.More typical symptoms of vitamin B12 deficiency anemia include:Diarrhea or constipationFatigue, lack of energy, or light-headedness when standing up or with exertionLoss of appetitePale skinProblems concentratingShortness of breath, mostly during exerciseSwollen, red tongue or bleeding gumsSymptoms from nerve damage caused by vitamin B12 deficiency that has been present for a longer time include:Confusion or change in mental status (dementia) in severe casesDepressionLoss of balanceNumbness and tingling of hands and feetSigns and testsA physical exam may show problems with reflexes or a positive Babinskireflex.The following tests may be done:CBCReticulocyte countSchilling test(if pernicious anemia is suspected)Serum LDHSerum vitamin B12 level and serum folate levelsEsophagogastroduodenoscopy(EGD) to examine the stomach, or enteroscopy to examine the small intestine may be done.Bone marrow biopsy is done only when the diagnosis is not clear.TreatmentTreatment depends on the cause of B12 deficiency anemia.Pernicious anemia requires lifelong vitamin B12 replacement, most often using injections. Some patients can get enough supplementation with high-dose tablets of oral vitamin B12.People with anemia due to a lack of dietary vitamin B12 may be told to take vitamin supplements and follow a more balanced diet. Treatment may start with vitamin B12 injections.Anemia caused by poor digestion and absorption is treated with vitamin B12 injections until the condition improves. These shots are given every day and then every week at first, and then every month.Many people may need these shots once a month for the rest of their life. The shots may no longer be needed after Crohn's disease, celiac disease, or alcoholism is properly treated.Expectations (prognosis)Treatment for this form of anemia is usually effective.Any damage to nerves may be permanent, especially if treatment is not started within 6 months of when the symptoms begin.ComplicationsVitamin B12 affects cells that form the outer surface of the body and line inner passageways (epithelial cells). Therefore, a lack of B12 may cause a falsely abnormal Pap smear.Calling your health care providerCall your health care provider if you have any of the symptoms of anemia.PreventionYou can prevent anemia caused by a lack of vitamin B12 by following a well-balanced diet. Vitamin B12 injections can prevent anemia after surgeries known to cause vitamin B12 deficiency. Early diagnosis and prompt treatment can limit the severity and complications of this anemia.ReferencesAntony AC. Megaloblastic anemias. In: Hoffman R, Benz Ej, Shattil SS, et al., eds. Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone;2008:chap 39.Kaferle J, Strzoda CE. Evaluation of macrocytosis. Am Fam Physician. 2009;79:203-208.
