| Subject | Contents |
| Definition | A diagnostic procedure in which a portion of the lining of the small bowel (small intestine) is removed for examination.
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| Alternative Names | Biopsy - small bowel |
| How the test is performed | Small bowel biopsy samples can be obtained by EGD (esophagogastroduodenoscopy) '>EGD (esophagogastroduodenoscopy) or other endoscopy of the upper gastrointestinal tract. A flexible fiberoptic tube (endoscope) is inserted through your mouth or nose and into the upper gastrointestinal tract. Tissue samples removed during endoscopy are sent to the laboratory for examination. Capsule biopsy produces a larger sample of the intestinal lining ( mucosa ) and allows sampling of areas that are beyond the reach of the endoscope. The procedure is similar to that of EGD . The back of your throat is sprayed with a local anesthetic to prevent gagging. The tube and capsule is inserted through your mouth and you are asked to swallow as the tube is advanced. The position may be changed from sitting to lying on the right side to help the capsule advance through the stomach and into the small bowel. When the capsule is properly positioned, suction is applied to the tube (which causes the capsule to close and grab tissue). Once a tissue sample has been obtained, the tube and capsule are removed. |
| How to prepare for the test | Fasting for at least 8 hours is recommended. You must sign an consent form.
Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:infant test or procedure preparation (birth to 1 year) toddler test or procedure preparation (1 to 3 years) preschooler test or procedure preparation (3 to 6 years) schoolage test or procedure preparation (6 to 12 years) adolescent test or procedure preparation (12 to 18 years) |
| How the test will feel | The passage of the tube and capsule often makes a person feel like gagging (topical anesthetic is used to minimize this sensation). A mild sedative can be given, but only in small doses because the person must remain alert enough to assist with the procedure (by doing such things as swallowing and turning). The biopsy sampling causes little or no pain, although it may cause some mild cramping. |
| Why the test is performed | This test is most often performed to help diagnose diseases of the small intestines. |
| Normal Values | Normal small bowel tissue includes finger-like projections (villi), crypts, columnar epithelial cells, and round cells. |
| What abnormal results mean | Abnormal findings may include: abnormalities of the mucosa or villi (for example, flattening)radiation enteritis PAS positive macrophages dilated intestinal lymph nodes or lymphatic vessels Disorders and conditions that may be indicated by changes found on small bowel biopsy include:celiac spruecoccidiosisfolate or Vitamin B12 deficiencygiardiasis infectious gastroenteritisinflammation of the small bowel Crohn's disease amyloidosis lymphangiectasialymphomamalnutritiontropical sprueWhipple's disease Additional conditions under which the test may be performed: lactose intolerance |
| What the risks are | Complications are rare but may include: bowel perforation excessive bleeding from the biopsy site infection of the biopsy site leading to bacteremia (bacteria in the bloodstream)vomiting and subsequent aspiration into the lungs |
| Special considerations | Contraindications (factors that prohibit use of this test) may include uncooperative or confused patients, people taking aspirin or anticoagulants (greatly increases risk of bleeding ), and people with untreated coagulation (blood clotting) disorders. The greatest risk is bleeding. Signs include abdominal pain , blood in the stools , or vomiting blood . |
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