Enteroscopy

It is now more than 25 years since small bowel enteroscopy (SBE) was first described. For several reasons, this technique developed more slowly than o ther more usual forms of endoscopy. First, small bowel disease is relativel y rare in comparison with other gastrointestinal diseases. Also, there was lack of initial design agreement, and three different types of enteroscopes were developed within a short time of each other, two of which (push-type and sonde) are now available commercially. Finally, commercial interests of the manufacturers of endoscopes were mainly focused on the more convention al, large Volume markets. In the last few years, specifically designed modern small bowel enteroscope s have become available and, in centers that have access to them, they have superseded attempts at SEE using adult or pediatric colonoscopes. There ar e now clear indications for SEE, such as: the investigation of obscure caus es of bleeding and anemia; malabsorption; clarification of x-ray abnormalit ies; and, increasingly, the application of therapeutic endoscopy to lesions within the small bowel. Problem areas remain, but with advancing technolog y and more professional interest in this area, these will be addressed duri ng the next few years. (C) 2000 Lippincott Williams & Wilkins, Inc.