Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|rer1001 - Thu Dec 21, 2006 3:24 pm||
The results of my recent capsule endoscopy indicate that I have mild enteropathy in the proximal jejunum with erosions and denudement of villi. The gastroenterologist who did the capsule endoscopy recommended an enteroscopy, and I was all set to go ahead with it until he mentioned that he was not absolutely certain that it could be reached with the instrument available to him.
Are the instruments available in different lengths? Should I contact another medical center that does enteroscopies to see if a longer scope is available there?
Before the capsule endoscopy, I had asked about how the location of the capsule could be determined, and he told me that it was done with triangulation of the signals. Based on that, I assumed the location of any abnormality could be ascertained with fairly good accuracy. Maybe I don't understand the complications involved.
Would appreciate any information you could provide. Thanks in advance. rer1001.
|Dr. Safaa Mahmoud - Thu Dec 21, 2006 6:17 pm||
I am not expertise in this area but I will try to give you more information about this technique.
The Push-type enteroscopy can reach lengths in the range of (30-160 cm) in the jejunum depends on many factors including anatomical problems like strictures.
However for fear of complications (e.g.perforation) this technique is considered in cases of unexplained malabsoprtion, bleeding, abdominal pain for definitive management.
I think the fact that your Doctor did not encourage using this technique is what he said, may be they can not reach where the lesions are , as well as to avoid unnecessary complications if the diagnostic yield is not sufficiently expected.
Enetropathy can be due to many causes like infection, autoimmune and malignant disease, biopsy is essential for definitive diagnosis.
Keeping in mind that you have a mild degree of anemia, you better follow up with your docotr to check whether the condition is progressiong or improving.
Your Blood test results, showed iron deficiency anemia, that is probably due to blood loss(not proved as stool analysis was negative) and or diminished iron absorption (suggestive from the capsule enterosopy results).
In this case it might be logical to do a therapeutic test with oral iron, if no improvement in your blood tests (it is not then due to iron loss),
then a parenteral iron therapy may be tried, which should be effective in both causes. Other wise more investigations are needed.
If the condition is not responding to the current treatment and or the appearance of new symptoms, Further investigations are needed for proper diagnosis and managment.
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