What Is Small Bowel Enteroscopy?

What to expect when undergoing this test

An enteroscopy (also called a push enteroscopy) is a medical test that is used to look at the inside of the small bowel. It is a type of endoscopy procedure that may be used in the diagnosis and management of several different types of digestive conditions. This test is done using a special tool called a push enteroscope (or sometimes by using a pediatric colonoscope).

The enteroscope is a long, flexible tube with a camera on the end that is inserted through the mouth, down into the esophagus and stomach, and into the duodenum (the first portion of the small intestine). With the use of the enteroscope, a physician can actually see the inside of the digestive tract, including the stomach and small intestine, and take one or more small pieces of tissue (a biopsy) for study. In addition, because the small intestine is being accessed, it may be possible to administer therapy, such as removing a polyp.

Some enteroscopes have latex balloons in them and are used for double-balloon enteroscopy (DBE) or single-balloon enteroscopy (SBE). The endoscope has another tube inside it that can be used to reach further into the small intestine. The balloons are used during the test to anchor the endoscope in the digestive tract.

This technique may help see further into the digestive tract, sometimes into the last part of the small intestine, which is called the ileum. These techniques usually require specialized training to administer and make take longer to complete.

Enteroscopy procedure
Verywell / JR Bee 

Purpose of Test

There are several reasons why a doctor may want to look at the tissue inside the stomach and/or the small intestine. An enteroscopy is a way to examine the upper digestive system for any problems without using actual surgery. This test might be ordered after other tests (such as colonoscopy, X-ray, or barium tests) showed that there could be a problem in the digestive system or they did not show the reason for symptoms such as bleeding.

With a small bowel enteroscopy, the first (duodenum) and second (jejunum) parts of the small bowel can be seen.

Some of the signs and symptoms that may prompt a doctor to order this test include:

  • Bleeding in the digestive tract
  • Bowel obstruction
  • Increased white blood cell count
  • Malnutrition
  • Radiation treatment damage
  • Severe diarrhea
  • Suspected or confirmed tumors

Risks and Contraindications

An enteroscopy is a safe procedure but it might not be recommended in certain people, including those who are pregnant, have lung disease, have heart disease, or are obese. This test is usually done under anesthesia, so it may not be used for those who have had a bad reaction to anesthetic in the past or who may be adversely affected by anesthesia because of another disease or conditions.

Complications after an enteroscopy are rare. There are, however, some adverse effects that may occur after having the test, which should go away in a day or two. These can include:

  • Abdominal cramps
  • Abdominal bloating
  • Minor bleeding from any biopsy site(s)
  • Nausea
  • Sore throat

The rate of complications after enteroscopy is estimated to be very low, at about 1 percent. Some of the serious complications that have occurred include developing an inflammation of the pancreas (pancreatitis), severe bleeding, and a perforation (hole) in the small intestine.

Before the Test

The doctor’s office will provide instructions about how to prepare for the test. Certain medications may need to be stopped for a time, including anything that’s taken over the counter, such as Pepto Bismol or iron supplements. Any drugs that thin the blood, including non-steroidal anti-inflammatories such as aspirin, may need to be stopped for a week or more before the test because they can increase the risk of bleeding.

Check with the doctor about any medications or supplements to understand if and when they should be stopped and what medications can be continued and/or taken the day of the test.

Location

An enteroscopy is usually done either in an endoscopy center or a hospital.

What to Wear

Loose, comfortable clothing that is easy to get on and off in order to change into a hospital gown will be helpful. As a rule of thumb for any medical procedure, expensive jewelry should be left at home.

Food and Drink

This test works best when the stomach and small intestine are empty. The preparation for an enteroscopy is usually avoiding solid foods the night before the test, usually somewhere between 10 pm and midnight. Clear liquids may be allowed in the morning but they must be stopped several hours before having the test (about four hours), but the doctor’s office will provide more specific instructions.

Clear liquids usually include water, lemonade, lemon/lime soda, ginger ale, chicken or beef broth, and plain tea and coffee (without milk, creamer, or sugar). Call the doctor’s office if there are any questions about how to get ready for the test and when liquids are allowed and what type.

Cost

The average cost of an enteroscopy in the United States is around $2,500. There may be a cost-savings in having the test done at an outpatient endoscopy center versus having it in a hospital. In some cases, pre-approval may be needed from an insurance carrier before having this test, in order to make sure that it is covered by insurance. Call the number on the back of your insurance card to find out of a pre-approval is needed.

What to Bring

After having general anesthesia, you will not be allowed to drive yourself home, so a friend or relative will need to be there. Most institutions will not allow you to go home in a cab or a ride share service because of the grogginess that occurs after having the test.

There may be some waiting time, so bringing something to pass the time will be helpful. Bringing expensive or bulky electronics may not be recommended because they will often need to be left in the waiting room with a friend or relative during the test.

During the Test

After arriving at the endoscopy center or hospital, the process of getting ready for the test will start. The enteroscopy will be completed by a physician, but other medical professionals that will assist can include nurses, a nurse anesthetist, and an anesthesiologist.

Pre-Test

Checking in for a medical test usually means providing the front office staff with an insurance card and a form of identification (such as a driver’s license). Every institution will have slightly different processes, but in general, there will be forms to read and sign that pertain to the test. The person undergoing the procedure should ask questions if anything seems unclear or confusing.

You will be called back into the prep and recovery area to get ready for the test. It will be necessary to change into a hospital gown and put street clothes into a bag or sometimes into a locker. A nurse or other staff member will ask about medication any other medical conditions, and sometimes about who will be driving home from the test or other questions about life at home.

A nurse will set you up in a special hospital bed and an IV will be started for administering fluids and sedatives. Monitoring devices may also be used, such as a blood pressure cuff and a heart monitor to keep track of vital signs during the test. When it’s time for the test, the bed will be wheeled into the endoscopy suite, where the actual test will take place.

Throughout the Test

An enteroscopy may take anywhere from one to two hours to complete. The timing will depend on how long it takes the physician to complete the test and how much time is necessary for the recovery period.

After a patient is sedated, the physician will insert the endoscope into the mouth and slowly move it down and into the small intestine. For those who are awake or are lightly sedated, nursing staff will give instructions on how to communicate if there is a need to do so. There should be no pain or discomfort during the test.

Post-Test

After the test is over, you are taken back to the waiting area to wake up and recover before going home. The doctor may come to the bedside and discuss the initial results after the anesthetic has worn off but more detailed results, including those from any biopsies, will come at a later time.

There may be some bloating because air is pumped through the scope in order to better see the inside of the stomach and small intestine.

After the procedure, one may feel the need to expel gas while in recovery. Nurses will remove the IV and usually can offer you something to drink such as ginger ale or cranberry juice. You will stay in the recovery area for a few hours following the procedure.

After the Test

There may be a follow-up appointment after the test to discuss any results and potential next steps. You will be given instructions to follow after going home, but in general, it’s recommended to take it easy for the rest of the day and plan to rest. The next day most people can return to their regular activities, such as going to work or school. Ask the doctor about how long to wait before taking part in any vigorous exercise or other strenuous activities.

Most people will be able to eat soft foods shortly after the procedure. There may be a recommendation to avoid heavy meals, spicy foods, or fatty foods for the rest of the day.

Managing Side Effects

A small amount of blood in the stool and mild abdominal bloating may be experienced after this test. Call the doctor right away if there are any signs or symptoms such as:

  • Blood in the stool that’s more than a few tablespoons
  • Fever
  • Severe abdominal pain or camping
  • Severe bloating or a hard abdomen
  • Vomiting

Interpreting Results

The doctor may have some initial thoughts to share immediately after the test, so it’s good to have a friend or relative available to help listen to any important information. Further results, such as what will come from a pathology report of a biopsy, will take at least several days.

A follow-up appointment with the doctor might be needed to go over the results in more detail. At that point, if there are any findings that need treatment, those can be discussed and decisions can be made about management, more testing, or a referral to another physician.

A Word From Verywell

An enteroscopy is a type of endoscopy, which is an invasive test. However, the medical team will do everything possible to make the test as comfortable as possible. Always remember to tell the nurses and physicians about any other conditions and medications. You will need the day free, so take off from work or school, but the next day most people are well enough to go back to their activities. An enteroscopy is a very safe test and there are few complications. However, anything out the ordinary that happens after the test, such as severe pain or bleeding, is reason to seek medical attention right away.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Society for Gastrointestinal Enteroscopy. Balloon Assisted or “Deep” Enteroscopy


  2. National Institute of Diabetes and Digestive and Kidney Diseases. Upper GI Endoscopy


  3. American Society of Gastrointestinal Endoscopy. Understanding Upper Endoscopy


Additional Reading

  • ASGE Technology Committee, Chauhan SS, Manfredi MA, Abu Dayyeh BK, et al. Enteroscopy. Gastrointest Endosc. 2015;82:975-90. doi:10.1016/j.gie.2015.06.012.

  • Levy I, Gralnek IM. Complications of diagnostic colonoscopy, upper endoscopy, and enteroscopy. Best Pract Res Clin Gastroenterol. 2016;30:705-718. doi:10.1016/j.bpg.2016.09.005.