Enteroscopy Test: Purpose, Test Details & Results

Enteroscopy is a specialized endoscopic procedure that allows doctors to directly visualize and treat the small intestine, an area that is difficult to reach with standard upper or lower endoscopy. Whether you’re a patient facing this test or a curious reader, understanding the purpose, steps, and implications of enteroscopy can empower you to make informed decisions about your health. In this article, we’ll explore the reasons for enteroscopy, how the test is performed, and what results might mean for your care.

Purpose of Enteroscopy Test

Enteroscopy plays a vital role in investigating and managing various small intestine disorders, especially when other gastrointestinal tests yield inconclusive results. Its ability to both diagnose and treat conditions in a single session makes it a valuable tool for clinicians and patients alike.

Investigating Unexplained Gastrointestinal Bleeding

One of the most common reasons for enteroscopy is to investigate bleeding in the digestive tract that cannot be explained by standard tests like colonoscopy or upper endoscopy. Enteroscopy can uncover hidden sources of blood loss such as angiodysplasia (abnormal blood vessels), ulcers, or tumors in the small bowel. In patients with overt or obscure GI bleeding, enteroscopy often leads to a diagnosis and allows for immediate treatment of bleeding lesions 1 2 5 6.

Diagnosing Iron-Deficiency Anemia

When patients have iron-deficiency anemia and standard tests fail to explain the cause, enteroscopy is often the next step. It helps identify bleeding or absorptive disorders in the small intestine, which may be missed otherwise. Studies show that combining enteroscopy with upper endoscopy significantly increases the chance of finding the cause of anemia, making it a cost-effective diagnostic option 3 5.

Clarifying Abnormal Imaging Results

If imaging studies like barium X-rays or CT scans suggest abnormalities in the small intestine, enteroscopy provides direct visualization for a more definitive diagnosis. It can confirm or refute suspicious findings seen on imaging, helping to avoid unnecessary treatments or surgeries 1.

Therapeutic Applications

Beyond diagnosis, enteroscopy allows physicians to perform treatments, such as removing polyps, dilating strictures, placing feeding tubes, or cauterizing bleeding vessels. This dual role as a diagnostic and therapeutic tool makes enteroscopy especially valuable when time and precision are critical 1 5.

Enteroscopy Test Details

Understanding what to expect before, during, and after an enteroscopy can ease anxiety and help patients prepare for the procedure. Modern enteroscopy techniques are safe, effective, and performed with patient comfort in mind.

Types of Enteroscopy

• Push Enteroscopy: This is the most common technique, using a longer endoscope inserted through the mouth to reach the upper small intestine. It is generally performed on an outpatient basis and lasts between 10 and 45 minutes 1 3 5.
• Double-Balloon Enteroscopy (DBE): This advanced method uses two balloons to anchor and advance the scope deep into the small bowel. It allows for more extensive evaluation, especially when the source of bleeding or disease is further along the intestine 6.
• Intraoperative Enteroscopy: Performed during abdominal surgery, this method enables complete inspection of the small bowel and is reserved for cases where endoscopic techniques have failed or when a surgical approach is otherwise needed 2.

Preparation

• Patients are typically asked to fast for 6–8 hours before the procedure.
• Medications may be adjusted, especially blood thinners or diabetes medications, under doctor guidance.

During the Procedure

• Sedation is provided for comfort; most patients are conscious but relaxed.
• The endoscope is carefully advanced, allowing the physician to inspect the lining of the small intestine.
• If abnormalities are found, biopsies can be taken, and treatments like cauterization or polyp removal can be performed immediately 1 5.

Patient Comfort and Risks

• Most patients report minimal or mild discomfort during push enteroscopy 3.
• Risks are low but can include bleeding (especially if a lesion is treated), infection, or rarely, perforation of the intestine.
• Complications are rare and often minor, especially in experienced centers 1 5.

Innovations and Expanding Uses

• Newer techniques, like double-balloon enteroscopy, have expanded the reach and effectiveness of the procedure, helping to diagnose and treat previously inaccessible parts of the small intestine 6.
• Enteroscopy is increasingly used not just for diagnosis but also for endoscopic therapies, reducing the need for surgery in many cases 1 5.

Enteroscopy Test Results & Follow-Up

The results of enteroscopy can significantly impact a patient’s diagnosis and treatment plan. Rapid interpretation and appropriate follow-up are essential to ensure optimal outcomes.

Interpreting Results

• Positive Findings: If a bleeding source, tumor, or abnormal tissue is found, enteroscopy often enables immediate intervention (such as cautery, removal, or biopsy). This can lead to a rapid diagnosis and targeted therapy, often avoiding further invasive procedures 1 2 3 5.
• Negative Findings: Not all enteroscopies identify a cause. In some cases, lesions are outside the reach of the scope or are intermittent. Studies show that a proportion of patients with negative results may later experience recurrent symptoms, prompting repeat evaluation 6.
• Therapeutic Success: When lesions are treated during enteroscopy, such as cauterizing bleeding vessels or removing polyps, patients typically require follow-up to ensure the problem does not recur 1 5 6.
• Artifacts/Inconclusive: Occasionally, findings may be due to artifacts or non-significant changes, requiring further imaging or a repeat test for clarification 1 6.

Impact on Patient Management

• Enteroscopy findings frequently lead to changes in patient management, including alteration of medications, planning for surgery, or cessation of further tests if a clear diagnosis is made 5.
• In iron-deficiency anemia, for example, the addition of enteroscopy to standard endoscopy increases diagnostic yield from 41% to 67%, directly influencing treatment plans and reducing unnecessary costs 3.

Long-Term Outcomes and Recurrence

• Patients with treated lesions (such as arteriovenous malformations) may have a risk of recurrence and require ongoing monitoring or repeat therapy 5 6.
• In cases where the initial enteroscopy is negative, up to a third of patients may later experience recurrent bleeding, often from sites within reach of the first procedure 6.

When to Repeat or Consider Alternative Tests

• If symptoms persist after a negative enteroscopy, repeat testing or alternative imaging (such as capsule endoscopy or CT enterography) may be necessary to uncover elusive or evolving pathology 4 6.
• Multidisciplinary discussion may be warranted for complex cases or when symptoms recur after an initially negative workup.

Conclusion

Enteroscopy is a powerful tool for diagnosing and treating small intestine disorders, especially when other gastrointestinal tests fall short. Its dual diagnostic and therapeutic capabilities can make a significant difference in patient outcomes.

Key takeaways:

• Enteroscopy is primarily used to investigate unexplained gastrointestinal bleeding, iron-deficiency anemia, and to clarify abnormal imaging results, offering both diagnostic and therapeutic solutions 1 2 3 5 6.
• Multiple techniques exist, including push enteroscopy, double-balloon enteroscopy, and intraoperative enteroscopy. Preparation is straightforward, and patient discomfort is generally minimal 1 3 5 6.
• Results from enteroscopy often lead to immediate treatment and changes in patient management. Negative findings may require follow-up or additional testing, especially if symptoms persist 5 6.
• The procedure is well-tolerated, with a low risk of complications, and is considered highly useful by clinicians for guiding care 1 3 5.

By understanding the role, process, and implications of enteroscopy, patients and families can engage more fully in their healthcare journey and work collaboratively with their care teams to achieve the best possible outcomes.