Intestine endoscopy: Small Bowel Endoscopy | Penn State Health

23.12.202113.07.2023 by alexxlab

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Small Bowel Endoscopy | Inflammatory Bowel Disease | Henry Ford Health

Minimally invasive procedure for diagnosing IBD.

Your small intestine, also known as the small bowel, connects the stomach to the large intestine (colon). The small bowel is often the site of painful conditions, such as Crohn’s disease or celiac disease (an immune disease in which eating foods with gluten leads to damage in the small intestine).

At Henry Ford, we use several diagnostic procedures to determine the cause of your discomfort, where in your digestive tract the issue is located and how severe the issue is. One of these procedures is small-bowel endoscopy, also known as deep endoscopy. Some other digestive centers don’t offer small-bowel endoscopy because of the time and coordination involved in the procedure, but it’s a valuable tool that helps us accurately diagnose our patients.

Our team includes specialists in inflammatory bowel disease (IBD) with the expertise you need for a precise diagnosis and comprehensive treatment. No matter what’s causing your symptoms, we’re here to help.

What is a small-bowel endoscopy?

A small-bowel endoscopy is a minimally invasive procedure in which we examine your entire small intestine, which is about 20 feet long. We use special balloons that fit over a thin, flexible tube called an endoscope, which has a light and a video camera. By inflating and deflating the balloons, we move the small bowel over the endoscope so we can examine it.

The endoscope lets us see nearly any part of the small bowel so we can diagnose the cause of your symptoms. We also can treat your condition if needed with the help of tiny tools we pass through the endoscope and into your small bowel.

What’s the difference between a small-bowel endoscopy and a colonoscopy?

While small-bowel endoscopy and colonoscopy are both types of endoscopy, the procedures are very different. Because Crohn’s disease can affect any part of the digestive tract, we use small-bowel endoscopy for its greater ability to view any part of the digestive tract. Colonoscopy, by contrast, lets us view changes and areas of concern in the large intestine (colon) only.

Because of a colonoscopy’s more limited viewing area, a small-bowel endoscopy is the better choice for locating and diagnosing Crohn’s disease.

What to expect during your small-bowel endoscopy

Before your procedure, we’ll give you instructions on how to prepare for your small-bowel endoscopy. You may need to fast (not eat or drink) before your endoscopy so your stomach is empty for the procedure.

If you take certain blood-thinning medications, you may need to stop taking them in the days before your endoscopy, as these medications can increase your risk of bleeding during the procedure. Your doctor will give you instructions about any medications you may take for chronic conditions, such as diabetes, heart disease or high blood pressure.

On the day of your procedure, one of our expert anesthesiologists will sedate you. While you’re sedated, your doctor will pass the endoscope through your mouth and stomach and into the small intestine. You will not feel any pain during your endoscopy.

The procedure will last an hour or two. Afterward, you’ll rest until your sedation wears off. You won’t be able to drive, so please plan on having someone available to take you home.

Bile reflux – Symptoms & causes

Overview

Bile reflux occurs when bile — a digestive liquid produced in your liver — backs up (refluxes) into your stomach and, in some cases, into the tube that connects your mouth and stomach (esophagus).

Bile reflux may accompany the reflux of stomach acid (gastric acid) into your esophagus. Gastric reflux may lead to gastroesophageal reflux disease (GERD), a potentially serious problem that causes irritation and inflammation of esophageal tissue.

Unlike gastric acid reflux, bile reflux can’t be completely controlled by changes in diet or lifestyle. Treatment involves medications or, in severe cases, surgery.

Bile reflux

Bile is a digestive fluid produced by the liver and stored in the gallbladder. During bile reflux, digestive fluid backs up into the stomach and, in some cases, the esophagus.

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Symptoms

Bile reflux can be difficult to distinguish from gastric acid reflux. The signs and symptoms are similar, and the two conditions may occur at the same time.

Bile reflux signs and symptoms include:

Upper abdominal pain that may be severe
Frequent heartburn — a burning sensation in your chest that sometimes spreads to your throat, along with a sour taste in your mouth
Nausea
Vomiting a greenish-yellow fluid (bile)
Occasionally, a cough or hoarseness
Unintended weight loss

When to see a doctor

Make an appointment with your doctor if you frequently experience symptoms of reflux, or if you’re losing weight without trying.

If you’ve been diagnosed with gastroesophageal reflux disease (GERD) but aren’t getting enough relief from your medications, call your doctor. You may need additional treatment for bile reflux.

Causes

Bile is essential for digesting fats and for eliminating worn-out red blood cells and certain toxins from your body. Bile is produced in your liver and stored in your gallbladder.

Eating a meal that contains even a small amount of fat signals your gallbladder to release bile, which flows through a small tube into the upper part of your small intestine (duodenum).

Bile reflux into the stomach

Bile and food mix in the duodenum and enter your small intestine. The pyloric valve, a heavy ring of muscle located at the outlet of your stomach, usually opens only slightly — enough to release about an eighth of an ounce (about 3.75 milliliters) or less of liquefied food at a time, but not enough to allow digestive juices to reflux into the stomach.

In cases of bile reflux, the valve doesn’t close properly, and bile washes back into the stomach. This can lead to inflammation of the stomach lining (bile reflux gastritis).

Bile reflux into the esophagus

Bile and stomach acid can reflux into the esophagus when another muscular valve, the lower esophageal sphincter, doesn’t work properly. The lower esophageal sphincter separates the esophagus and stomach. The valve normally opens just long enough to allow food to pass into the stomach. But if the valve weakens or relaxes abnormally, bile can wash back into the esophagus.

What leads to bile reflux?

Bile reflux may be caused by:

Surgery complications. Stomach surgery, including total or partial removal of the stomach and gastric bypass surgery for weight loss, is responsible for most bile reflux.
Peptic ulcers. A peptic ulcer can block the pyloric valve so that it doesn’t open or close properly. Stagnant food in the stomach can lead to increased gastric pressure and allow bile and stomach acid to back up into the esophagus.
Gallbladder surgery. People who have had their gallbladders removed have significantly more bile reflux than do people who haven’t had this surgery.

Complications

Bile reflux gastritis has been linked to stomach cancer. The combination of bile reflux and acid reflux also increases the risk of the following complications:

GERD. This condition, which causes irritation and inflammation of the esophagus, is most often due to excess acid, but bile may be mixed with the acid.
Bile is often suspected of contributing to GERD when people respond incompletely or not at all to powerful acid-suppressant medications.
Barrett’s esophagus. This serious condition can occur when long-term exposure to stomach acid, or to acid and bile, damages tissue in the lower esophagus. The damaged esophageal cells have an increased risk of becoming cancerous. Animal studies have also linked bile reflux to Barrett’s esophagus.
Esophageal cancer. There’s a link between acid reflux and bile reflux and esophageal cancer, which may not be diagnosed until it’s quite advanced. In animal studies, bile reflux alone has been shown to cause cancer of the esophagus.

What is bowel endoscopy: how to prepare and undergo an examination, indications and contraindications

Bowel endoscopy is a type of diagnostic examination that allows you to see the state of this organ from the inside. It is performed using an endoscope – a flexible device equipped with light, a camera, and in some cases a needle for biopsy (taking a tissue sample for examination in a laboratory).

Types of endoscopy

There are several main types of endoscopic examination of the intestine:

Capsule – used to examine the small intestine; the patient swallows the capsule, which contains a camera that takes pictures as it moves; data is transmitted using a sensor, and the capsule itself subsequently leaves the body naturally
Colonoscopy – endoscopic examination of the large intestine; a tube of small diameter and long length (up to one and a half meters) is inserted through the rectum
Esophagogastroduodenoscopy – used to examine the esophagus, stomach, and the initial area of the small intestine; during the procedure, a gastroscope (a type of endoscope) is inserted into the patient through the oral cavity and pharynx to a depth of 30 cm
Sigmoidoscopy – endoscopic examination of the rectum; during the procedure, an endoscopic device

is inserted through the rectum to a depth of 30 centimeters

Indications for bowel endoscopy

Each type of bowel endoscopy is used to identify different diseases:

Capsule

Bleeding from the area of the small intestine
Crohn’s disease
Iron deficiency anemia
Neoplasms of the small intestine

Colonoscopy

Discharge of blood, mucous or purulent masses from the intestines
Pain in the anus
Inflammation, colitis
Change or disturbance of stool

Esophagogastroduodenoscopy

Peptic ulcer
Gastritis
Bleeding
Violation of the digestive tract
Suspicion of a malignant tumor

Sigmoidoscopy

Chronic hemorrhagic disease
Probability of neoplasm in large intestine
Paraproctitis
Suspected prostate tumor (in men)

The doctor may also send the patient for an endoscopic examination of the colon, small intestine, or rectum if symptoms such as:

Abdominal pain of unknown origin
Foreign body in intestines
Gastric or intestinal obstruction
Weight loss with anemia, high fever
Bleeding from the gastrointestinal tract

Endoscopy can also be done to monitor results after surgery.

Contraindications

Endoscopic examination of the intestine is not performed if the patient:

Diagnosed with severe ulcerative colitis
Impaired blood clotting
Bowel perforation suspected
Abnormal enlargement of the colon (toxic megacolon)
State of shock
Severe mental disorders
Inflammatory or edematous lesions of the areas through which the endoscope will be inserted
Acute heart disease
Allergic reactions

Preparing for your procedure

Preparing for an endoscopic examination of the intestine consists of two main steps:

Diet 2 days before procedure
Cleansing the gastrointestinal tract from food debris and feces on the eve of the procedure

Diet includes:

Lean boiled fish or chicken
Dairy products
Lean biscuits (biscuits, etc. )

Should be eliminated from the diet:

Milk
Black bread
Kvass
Legumes (beans, peas, etc.)
Cereals (millet, oatmeal, etc.)
Fresh (not cooked) fruits, berries, vegetables, herbs

Cleansing of the gastrointestinal tract should be carried out with an enema or special preparations (they may be prescribed by a doctor).

How bowel endoscopy is performed

The procedure depends on the type of procedure.

Capsule endoscopy:

The patient swallows a capsule with a camera
The camera moves through the digestive tract and takes pictures
Images are transferred to the doctor’s computer
Specialist can control the camera, turn it on or off temporarily
The patient can be in any position, engage in various activities
Treatment lasts 8-9 hours
The camera is removed from the body of the subject in a natural way

Colonoscopy:

The patient lies on his side with his legs drawn up to his stomach (he lies on his back when necessary)
Physician administering local anesthesia
The device is placed in the patient’s rectum to a depth of 30 cm
If necessary, during the manipulations, medical procedures can be carried out: removal of a neoplasm, stop bleeding, removal of a foreign body
Colonoscopy lasts 30 minutes to 1 hour

Esophagogastroduodenoscopy:

The patient lies on the left side
Physician applying local anesthesia
The endoscope is placed through the mouth into the esophagus and then into the stomach and duodenum
According to the indications, small foreign bodies can be removed during the examination, and a tissue sample can be taken for laboratory testing
The procedure lasts 5-20 minutes (depending on the manipulations to be carried out)

Sigmoidoscopy:

The patient stands in the knee-elbow position on the couch
Doctor examines the anus by palpation
The instrument is lubricated with petroleum jelly and inserted into the rectum
The specialist removes the stop and places the endoscope further
The tip of the device moves along the intestinal lumen
Treatment lasts 10-15 minutes

Advantages of the procedure at MEDSI

MEDSI clinics are equipped with modern equipment – video endoscopic systems and instruments from the Japanese company Olympus and German Xion – which allows you to make the diagnosis most accurately and quickly
Application of various types of endo-procedures and other diagnostic methods
If necessary, doctors of related profiles are involved in the diagnosis
Patients are offered a comfortable hospital and international level service

To make an appointment for a consultation, call the round-the-clock phone 8 (495) 7-800-500.

Do not delay treatment, see a doctor now:

Endoscopy
Endoscopy Center at CDC on Krasnaya Presnya
MSCT of the intestine (virtual colonoscopy)

Endoscopy – what it is, what are the advantages

Endoscopy is an invasive method for examining hollow organs using endoscopes – flexible tubes equipped with a light source and passages for inserting surgical instruments. Endoscopic research methods are widely used in proctology, gastroenterology, otolaryngology, oncology, surgery and other areas of medicine.

The uniqueness of the method is due to its accuracy and information content. During the procedure, the doctor can take the material for a histological examination, carry out a number of therapeutic measures, and reliably assess the condition of the membranes lining the organ. Endoscopy – what kind of procedure it is, what are the advantages – experts will answer these and other questions in the article below.

Possibilities of endoscopy

Endoscopy is considered a universal method for detecting diseases of hollow organs and entire systems. The procedure is prescribed as a primary or differential diagnosis. The possibilities of endoscopic examination are wide:

early diagnosis of structural changes in mucous membranes, tumors;
detection of erosive foci, polyps, diverticula, ulcers;
determination of infectious and inflammatory foci;
tissue biopsy with biopsy sampling for histological analysis;
administration of drugs for the purpose of antibacterial or antiseptic treatment of a hollow organ;
laser treatment, cryodestruction method (for example, when removing polyposis formations).

Thanks to endoscopy, low-traumatic surgical interventions, catheterization, bypass procedures can be performed.

Scope

Rigid or flexible endoscopes (fiberscopes) are used in endoscopy. Flexible have a fiberglass structure – an image conductor to a computer.

Today, video endoscopes equipped with a miniature video camera are more commonly used. The device transmits information to the computer in real time. The tube of rigid endoscopes is made of metal. Main types of endoscopes:

arthroscope – study of articular structures;
hysteroscope for examining the internal female genital organs;
colonoscope – allows you to examine the large intestine;
proctosigmoscope – the equipment allows diagnosing diseases of the rectum and sigmoid colon;
tracheobronchoscope – examines the airways;
laparoscope – used in the diagnosis of diseases of the peritoneum and abdominal space;
gastroscope (esophagogastroduodenoscope) – the equipment allows you to evaluate the organ complex of the upper digestive tract;
cystoscope – a device used in urology, nephrology and gynecology for the diagnosis of diseases of the genitourinary system.

The endoscopy procedure is named according to the equipment chosen. So, when using a colonoscope as part of the diagnosis of proctological diseases, they talk about colonoscopy, when using an arthroscope, about conducting arthroscopy, if necessary, studies of the gastrointestinal tract suggest fibrogastroduodenoscopy.

How an endoscopy is done

Endoscopic examination is carried out through natural anatomical passages. The procedure is often performed under local anesthesia to maintain patient contact on an outpatient basis. Sometimes the question of the need for anesthesia is decided.

In some cases, such as laparoscopy, the insertion of the equipment is carried out through punctures. In this case, patients are in the hospital until the state of health normalizes.

Endoscopic technique is widely used for appendicitis, removal of the gallbladder, tumors, heart bypass. Endoscopy in surgery reduces the invasiveness of the operation, accelerates the recovery of patients and minimizes intra- and postoperative complications.

The most common endoscopic examinations

Most often, endoscopy is performed in gastroenterological and proctological practice. These studies are distinguished by their availability and good tolerability by patients. How is endoscopy performed in the study of the upper and lower digestive tract, the genitourinary system.

FGDS or fibrogastroduodenoscopy

Performed when the patient complains of discomfort and pain in the stomach, in preparation for abdominal surgery, for dynamic control of the prescribed treatment. The procedure is performed on an outpatient basis and lasts no more than 5 minutes.

The gastroscope is inserted into the patient through the oropharynx, having previously treated the throat with a solution of lidocaine. The patient is fitted with a mouthpiece, which must be clamped with teeth. At the deep entrance, the endoscope is immersed through the esophagus to the stomach. Inspection is carried out with the injection of air into the cavity of the stomach to straighten the mucous membranes for better visualization.

At the end of the examination, the doctor makes a conclusion. If necessary, take pictures, fix the nuances of the study.

Intestinal examination

Endoscopy of the intestine or colonoscopy is a common method for detecting diseases of the large intestine, various pathological changes in the membranes. Examination of the lining mucous membranes and the walls of the organ is performed using a flexible endoscope for therapeutic and diagnostic purposes. Indications for intestinal endoscopy are:

heaviness during emptying, constipation, episodes of intestinal obstruction;
ulcerative erosive process;
bleeding of the digestive tract;
pain;
polyps, neoplasms.

In diseases of the rectum in the sigmoid segment of the intestine, sigmoidoscopy is indicated. The study is carried out using a proctoscope – a tube with a lighting device and an air injection mechanism. Sigmoidoscopy allows you to assess the length of the intestine up to 22-30 cm from the entrance to the anus.

Genitourinary system

Endoscopy in urology or gynecology is a ureteroscopy or cystoscopy procedure. Both methods can detect diseases of the bladder and urinary tract.

Cystoscopy allows you to evaluate the function of the kidneys, the condition of the bladder, the presence of foreign bodies, foci of ureteral stricture. With the help of a cystoscope, it is possible to carry out procedures for instilling the bladder with antibacterial drugs, antiseptics for chronic cystitis, install a urethral catheter, and take tissues for histological examination.

Today, endoscopy is the method of choice in the diagnosis of hollow organs, along with ultrasound examination. The procedure has a wide range of indications and possibilities. After an endoscopic examination, the reliability of the final diagnosis increases dramatically. Modern diagnostic approaches minimize discomfort and pain for patients.