Most cases of bleeding in the digestive system are bleeding in the upper part of the digestive system, such as: esophagus, stomach, and duodenum, or from the lower part, such as: bleeding in the large intestine. Very few cases of bleeding originate from the small intestine, and the fact is that until recently it was not possible to detect the sources of bleeding in the small intestine without very invasive examinations.
Gastrointestinal endoscopy is a relatively new examination that is used to diagnose conditions of which the small intestine is a part, and especially to diagnose sources of bleeding that are not diagnosed by regular examination, such as:
Gastroscopy.
Colonoscopy.
When is the examination performed?
The main reason for conducting this examination is to complain of bleeding in the digestive system, and to undergo a gastroscopy and colonoscopy examination without reaching a result.
Another reason is the suspicion of Crohn''s disease, after the normal examination that includes gastroscopy, colonoscopy, and radiographs with barium, without reaching a result.
category at risk
It is not recommended for the following people to have a gastroscopy examination
Those who have a narrowing of the digestive system, a fistula, or an intestinal obstruction.
People whose medical history includes a number of surgeries in the abdominal area, as this increases the risk of blockages.
People who suffer from slow bowel functioning, which is often caused by diabetes.
pregnant women.
People with swallowing problems.
People who are required to have an MRI scan.
When there is a suspicion that the capsule could get stuck inside the body, a proactive examination can be conducted that includes a capsule with a transmitter only, and it is made of self-degrading materials Because it does not pose any risk, this examination helps the doctor to predict whether the video capsule will be stuck in the intestine during the examination.
related diseases
Related diseases include
Angiodysplasia of the small intestine.
Hidden bleeding in the gastrointestinal tract (Occult bleeding).
Crohn''s disease.
Tumors in the small intestine.
The method of conducting the examination
During a gastrointestinal endoscopy examination, a special single-use capsule containing a camera and a transmitter is swallowed. The capsule passes through the digestive system and transmits images from there to a device placed on the patient''s body. After that, the doctor reviews the images and determines the source of bleeding.
Prepare for the examination
The results of the capsule examination may show that the patient must undergo surgery to remove the bleeding part of the small intestine. If the patient rejects the idea of operating, this examination will not have any medical benefit for the patient, and he must consult the doctor in this regard.
Today there are a large number of types of gastroscopy, depending on the capsule
to pass through the small intestine.
to pass through the large intestine.
to pass through the esophagus and stomach.
The type of preparations that must be done varies according to the type of examination. Preparations for this examination include the following:
Diet: A specific diet must be followed, often a diet based on clear liquids during the day preceding the examination. You must also fast completely ten hours before the examination, and you must follow the doctor’s instructions and be careful to follow them.
Medications: If you are taking certain medications continuously, you should consult your physician. This is because it is forbidden to take any medication two hours before the examination unless you are explicitly asked to do so.
Applying powders: It is not permissible to put any kind of creams or powders on the body during the examination day.
Clothing: The patient must come in two-piece clothing, that is, it is not a dress, and it must not be sticky to the body or transparent.
during the examination
The patient will be worn with a belt that carries the receiver for broadcasting and its battery, and this device is connected to a number of electrodes attached to the abdomen. After operating the device, the patient will be asked to swallow the capsule. After about two hours, the patient can start drinking clear and transparent liquids, and after four hours he will be able to eat Snack.
During the gastrointestinal endoscopy examination, the patient must remain alert and check the lights of the device if they turn on and off based on the instructions he received. The gastrointestinal endoscopy examination takes 8 to 9 hours, but if during this period the patient feels any abdominal pain, nausea or the need to vomit He should immediately go to the doctor.
The capsule should pass automatically through the stool, it should not be painful, and the equipment should not be removed or moved on the body.
after examination
After about nine hours, it is possible to return to eating normally, if the patient is not sure that the capsule has left his body, and if he feels abdominal pain, nausea, or the need to vomit, he should immediately go to the doctor.
It is absolutely forbidden to perform a magnetic resonance imaging (MRI) examination if it is not certain that the capsule has left the body, because the magnetic field produced by the magnetic resonance examination can cause the capsule to move more quickly, which may lead to perforation of the intestine.
After completing the capsule examination, the equipment and tools must be handed over to the doctor as soon as possible. Care must be taken not to expose the machines to shocks, blows, strong sunlight, or vibrations.
[video|12|Watch the video: About magnetic resonance imaging - MRI
Analysis of the results
The doctor analyzes the set of images obtained from the device, and records the results of this analysis. Proper results mean that there was no source of bleeding, stenosis, or any other disorders.
In some cases, the capsule does not succeed in imaging some disorders despite its presence, especially if it is very small. In such cases, if bleeding or anemia persists, the patient may be directed to perform other more invasive examinations, such as: double balloon enteroscopy ).
As for the improper results, they usually indicate the type and location of the disorder. One of the most common disorders in such cases is angiodysplasia, which is a benign tumor in the blood vessels that usually appears in the small intestine and leads to chronic bleeding. It is the best treatment for this disorder that leads to anemia. Severe blood loss is surgical excision.
