Enteroscopy (English version)


Enteroscopy is an an incisionless and painless procedure of using an endoscope for the direct visualization of the small bowel. Deeper evaluation of the small bowel can be accomplished with enteroscopes coupled with a specialized overtube apparatus. The procedure can be performed via the mouth or via the anus.

Current options for device-assisted enteroscopes include double-balloon enteroscopy (DBE), single-balloon enteroscopy (SBE), spiral enteroscopy, and “on-demand” balloon assisted enteroscopy. By using both routes (via the mouth and the anus) it is possible to examine the whole small bowel in most of the patients. 

Enteroscopy technology and techniques have evolved significantly and allow diagnosis and therapy deep within the small bowel, previously attainable only with intraoperative enteroscopy. Although limited small-bowel evaluation is undertaken during standard upper endoscopy (esophagogastroduodenoscopy) and is possible during colonoscopy, enteroscopy typically refers to more extensive endoscopic examination of the small intestine.

In our center we are using single balloon enteroscopes (SBE) for small bowel examination. The duration of enteroscopy can be affected by many issues including patient factors such as obesity, surgical history, and intra-abdominal adhesions, and technical factors such as endoscopist expertise. Mean procedure times are 60 minutes for antegrade approach (via the mouth), and 69 minutes for retrograde approach (via the anus). The diagnostic and therapeutic yield is up to 70%. It is possible to examine the full length of small bowel through both approaches performed in different days.

How should I prepare for my enteroscopy?

If you are having enteroscopy via the mouth:

You should not have anything to eat or drink for approximately 8 hours before your procedure.  Typically, patients are asked to refrain from eating or drinking after midnight the night before their examination.

If you are having enteroscopy via the anus:

If you are having an examination of the lower small bowel from below you will need to take bowel preparation to clear out the colon.  One day before the procedure you should take clear fluids only (no solid food) e.g. glucose drinks, tea and coffee with sugar, clear soups, bouyont and fruit jelly. In addition you will need to take a laxative. Our endoscopy unit nurse will give you a booklet including clear instructions on how to administer your laxatives, and dietary restrictions. If you have any queries do not hesitate to contact the endoscopy unit and our nurse team will assist you.

Your physician may ask you to hold any anti-agregant or anti-coagulant (blood thinning) medications for 5-7 days before your test depending of your situation or if sampling is needed. You may be allowed to take your other medications on the morning of your test.  It is extremely important that you tell your physician what medications you are on (like aspirin, ecopirine, plavix (clopidogrel), eliquis, pradaxa, xarelto, lixiana, coumadine) and discuss if any need to be stopped before the test. 

What are the reasons why I need an enteroscopy*?

  • Identify and treat the source of  bleeding located in small bowel.
  • Take tissue samples to examine for a laboratory diagnosis (biopsy).
  • Remove small bowel polyps or a foreign object.
  • Enlarge a narrowed pathway (stricture) in the gastrointestinal tract.

  *Shown are common indications. Rare reasons not listed.


The overtube is backloaded onto the enteroscope, and the enteroscope is advanced as far as possible into the small bowel, then anchored by using its flexible tip. Subsequently, the overtube is advanced with its balloon deflated to the tip of the enteroscope. The overtube balloon is then inflated while keeping the enteroscope tip flexed. The entire apparatus is then withdrawn to allow pleating of the small bowel over the enteroscope and overtube. The enteroscope is then re-advanced while keeping the overtube balloon inflated to prevent slippage of the proximal bowel that has been pleated on the overtube. When the enteroscope cannot be advanced further, its tip is again flexed to anchor the enteroscope. The overtube balloon is then deflated, and the overtube is again advanced to the tip of the enteroscope. This sequence is repeated until the apparatus has advanced to the maximal, or to the desired extent within the small intestine. The point of final enteroscope advancement can be marked with a submucosal tattoo.

After the procedure

You will be allowed to rest for as long as is necessary. Your blood pressure and heart rate will be recorded and if you are diabetic, your blood glucose will be monitored. Once you have recovered from the initial effects of the sedation (which normally takes 30-60 minutes), you will offered light foods. Before you leave the department, your doctor will discuss the findings and any medication or further investigations required. As you will have sedation you will not be permitted to drive so you must arrange for a family member or friend to collect you. For inpatients no accompanying person needed.