Deep Enteroscopy

What is a Deep Enteroscopy?

Not to be confused with a gastroscopy and a colonoscopy, a deep enteroscopy helps your gastroenterologist in Singapore explore areas of the small intestine that are usually inaccessible to the two former techniques.

A deep enteroscopy involves a conventional endoscope that has a camera and light at one end, and in addition to that, one or two balloons, a pressure control unit, and a spiral may also be attached. The pressure control unit helps with the inflation and deflation of the attached balloons.

How does a Deep Enteroscopy work?

The small intestine is approximately 6 metres long, whereas an endoscope is only 2 metres long – this leaves a majority of the small intestine unreachable. Deep enteroscopies have now made these areas accessible. There are three types of deep enteroscopy:

Double balloon enteroscopy
Single balloon enteroscopy
Spiral enteroscopy

All three types can either be inserted via the mouth or the rectum, depending on the site of concern.

Double Balloon Enteroscopy (DBE)

Also known as a push-and-pull enteroscopy, the two balloons are inflated and deflated consecutively to allow the endoscope to advance deep into the small intestine.

Single Balloon Enteroscopy (SBE)

This procedure is similar to but less complicated than a double balloon enteroscopy. The single balloon inflates and anchors itself to the intestinal wall, which allows for the endoscope to advance. This process is repeated until the endoscope reaches where it needs to go.

Both types of balloon enteroscopy pleats the small intestines over and over, thereby shortening it which allows a 2-metre endoscope to explore the 6 metre long small intestine.

Spiral Enteroscopy

A rotating spiral is used to allow the endoscope to move back and forth in the small intestine.

You will either be placed under general anaesthesia or placed under a light sedative.
The endoscope and its attachments are gently inserted and maneuvered to begin exploring your small intestine.
The images are recorded and sent to a monitor for observation.
What happens next depends on the reason for your deep enteroscopy, such as collecting samples for a biopsy, widening constricted areas of your small intestine, or removing small obstructions.

How do I prepare for a Deep Enteroscopy in Singapore?

The ways to prepare for a deep enteroscopy depends on whether it is an upper deep enteroscopy or a lower deep enteroscopy.

If the procedure is performed in your upper digestive tract, you must refrain from drinking and eating for 6 hours prior.

If the procedure is performed in your lower digestive tract, you will be provided with a laxative drink or an enema to help clear out your bowels.

Always inform your gastroenterologist of any medication you are taking and if you are allergic to anything.

Who needs a Deep Enteroscopy?

There are various reasons why your gastroenterologist may choose to perform a deep enteroscopy on you. If you have the following issues, you may be required to undergo a deep enteroscopy:

Bleeding from your gastrointestinal tract
Tumour or precancerous growth and lesions
Bowel obstruction
Abnormal test results
Idiopathic diarrhoea
Idiopathic malnutrition or malabsorption
ERCP in patients with previous altered surgical anatomy

What can I expect after a Deep Enteroscopy in Singapore?

Immediately after the deep enteroscopy, you can expect to feel some mild discomfort and bloating - this is normal.

You may feel drowsy or nauseated for a few hours. You will have to wait for an hour or two until the sedative wears out and you might need a relative or friend to accompany you home as you will not be able to drive.

After the test, your doctor will inform you if he/she observed any abnormalities and if samples were taken for a biopsy. If such, your biopsy results should be ready in a few days and your doctor will call you with the results. The next step will depend on the results of your deep enteroscopy and if applicable, your biopsy.

What are the benefits of a Deep Enteroscopy?

Minimally invasive
Used for identifying and diagnosing various gastrointestinal issues without the need for surgery
Usually an out-patient procedure
Helps to remove cancerous growths and other lesions
Able to insert stents or widen constrictions if necessary

What are the possible complications or risks?

There are minimal to no risks or complications involved in a deep enteroscopy, however, if they do occur, this is what to look out for:

Reaction to the sedative: Some patients may experience problems with their breathing, heart rate, and blood pressure.
Perforation: A tear in the lining of your small intestine, which can be treated by the scope if detected early.
Bleeding: Some bleeding might occur along the walls of your small intestine if polyps or other growths and lesions were removed, and can be treated by the scope.
Sore throat: If an endoscope was inserted through the mouth, a sore throat may occur but it should resolve in a few days.
Nausea: Nausea can occur from the anaesthesia; this should subside in a few hours.
Abdominal pain: Mild discomfort after the procedure which should subside on its own.

Frequently asked questions

What is the difference between a deep enteroscopy and a colonoscopy or a gastroscopy?

Deep enteroscopies can explore areas of the small intestine that are inaccessible or unreachable for a colonoscopy or a gastroscopy.

How long does a deep enteroscopy take?

The whole procedure should take about 2 hours.

Must I stay overnight at the hospital?

Most of the time you do not need to stay overnight at the hospital, but this depends on the reason for your deep enteroscopy.

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