Push Enteroscopy
Push enteroscopy is an advanced endoscopic procedure used to examine a deeper portion of the small intestine beyond the reach of a standard upper GI endoscope.
A specialized longer endoscope is passed through the mouth into the upper and middle portions of the small intestine, allowing direct visualization of the intestinal lining. When required, targeted biopsies and selected therapeutic procedures can also be performed during the examination.
Push enteroscopy may be recommended when symptoms or previous investigations suggest an abnormality in the small intestine that requires further endoscopic evaluation.
Conditions
Push enteroscopy may be considered for selected small-bowel conditions, including:
- Suspected small-bowel bleeding
- Unexplained iron-deficiency anemia
- Small-intestinal lesions requiring direct assessment
- Abnormal findings identified on capsule endoscopy or imaging
- Selected inflammatory or mucosal abnormalities of the small intestine
- Small-bowel conditions requiring biopsy or endoscopic treatment
Symptoms
Symptoms that may lead to evaluation with push enteroscopy include:
- Unexplained gastrointestinal bleeding
- Black or tarry stools or recurrent blood loss
- Unexplained anemia
- Persistent abdominal discomfort or pain
- Unexplained weight loss
- Persistent diarrhea or changes in bowel habits
- Abnormal small-bowel findings on previous investigations
Causes
Several gastrointestinal conditions can affect the small intestine and may require evaluation beyond the reach of conventional upper GI endoscopy.
- Small-bowel vascular lesions causing bleeding
- Inflammatory conditions affecting the small intestine
- Small-intestinal polyps or tumors
- Mucosal abnormalities detected on previous tests
- Unexplained gastrointestinal bleeding after routine endoscopic evaluation
- Other suspected disorders involving the accessible small intestine
Treatment
During push enteroscopy, a longer endoscope is carefully advanced through the upper gastrointestinal tract into the small intestine. The lining is examined for abnormalities and appropriate endoscopic intervention can be performed when indicated.
Depending on the findings, the procedure may allow:
- Detailed visualization of the accessible small intestine
- Targeted biopsies for histopathological evaluation
- Endoscopic assessment of suspected bleeding sources
- Treatment of selected bleeding lesions
- Removal of suitable polyps or lesions
- Other targeted therapeutic interventions when clinically appropriate
The extent of examination and any therapeutic procedure are determined by the suspected condition, previous test results and the patient's clinical requirements.
Prevention & Follow-Up
Follow-up after push enteroscopy depends on the reason for the procedure, the findings and any treatment or biopsy performed during the examination.
Helpful measures include:
- Follow the preparation and post-procedure instructions provided by your doctor.
- Take prescribed medicines as directed.
- Attend follow-up to review biopsy or pathology results when samples are taken.
- Complete recommended imaging, laboratory tests or repeat endoscopy when advised.
- Report severe abdominal pain, significant bleeding, fever, repeated vomiting or other concerning symptoms after the procedure.
- Continue appropriate treatment and surveillance for the underlying gastrointestinal condition.
Further care is individualized according to the diagnosis and findings identified during push enteroscopy.