Enteroclysis

Enteroclysis is a radiographic examination, which allows to visualize the small intestine of the examined person. The small intestine is a poorly examinable organ. The endoscopic methods are great in examination of other parts of the gastrointestinal tract (upper GI endoscopy, colonoscopy). Endoscopic examination of the small intestine (double-balloon enteroscopy) is performed only in specialized gastroenterological departments.

Principle

The examination is done in horizontal position. A tube is inserted into the mouth or the nose and through the esophagus and stomach into the duodenum. At this point, a contrast agent (usually barium-based) and a solution of methyl cellulose are released from the tube. The methyl cellulose serves as a so-called negative contrast, which improves the outcome of the procedure.

During the procedure, repeated X-rays of the abdomen are done in certain time intervals. The X-ray images should show the flow of contrast through intestinal loops. The patient may be set to different positions to allow better flow of the contrast substance.

Preparation

The patient should not eat or drink before the examination. The last meal should be eaten at noon of the day before the enteroclysis and the patient should not drink any fluids at least 6 hours before the procedure.

Indications

Enteroclysis is indicated in diagnosis of many disease of the small intestine. It can show mucosal irregularities, polyps, tumor lesions and intestinal strictures and intestinal fistulas. From the above text it is clear that the examination is very valuable in diagnostics of Crohn's disease and its complications.

Disadvantages

The contrast agent may sometimes cause allergic reaction, which may rarely take form of a dangerous anaphylactic shock. In addition, the procedure exposes the patient to a dose of radiation, which is much higher than in a single abdominal X-ray. Enteroclysis with barium suspension should not be performed in patients suspected of having a hole in the digestive tract (such as intestinal perforation). Barium contrast could leak into the abdominal cavity, causing its inflammation (chemical peritonitis).

Advantages

Enteroclysis shows the cavity of the small intestine. It is a relatively non-invasive examination (with exception of introducing the tube into the digestive tract) and can be performed on an outpatient basis.

Note: Classic enteroclysis is more and more frequently replaced by a more modern and accurate method known as CT enteroclysis, which combines the enteroclysis with computed tomography of the abdomen.