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Optimising the use of small bowel endoscopy: a practical guide
  1. Stefania Chetcuti Zammit,
  2. David S Sanders,
  3. Mark E McAlindon,
  4. Reena Sidhu
  1. Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK
  1. Correspondence to Dr Stefania Chetcuti Zammit, Academic Department of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield S10 2JF, UK; Stefania.Zammit{at}


The wireless nature of capsule endoscopy offers patients the least invasive option for small bowel investigation. It is now the first-line test for suspected small bowel bleeding. Furthermore meta-analyses suggest that capsule endoscopy outperforms small bowel imaging for small bowel tumours and is equivalent to CT enterography and magnetic resonance enterography for small bowel Crohn’s disease. A positive capsule endoscopy lends a higher diagnostic yield with device-assisted enteroscopy. Device-assisted enteroscopy allows for the application of therapeutics to bleeding points, obtain histology of lesions seen, tattoo lesions for surgical resection or undertake polypectomy. It is however mainly reserved for therapeutics due to its invasive nature. Device-assisted enteroscopy has largely replaced intraoperative enteroscopy. The use of both modalities is discussed in detail for each indication. Current available guidelines are compared to provide a concise review.

  • small bowel disease
  • small bowel enteroscopy
  • small bowel

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  • Patient consent for publication Not required.

  • Contributors RS planned the manuscript and was involved in editing and revisions of the article. SCZ wrote and submitted the manuscript and was involved in corrections and editing. DSS and MMA were involved in revisions of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.