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Dr. Ankit Anand – Best Gastroenterologist in Jalandhar

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Obscure GI Bleeding

Small Intestinal Bleed Procedure in Jalandhar — When Both Scopes Were Normal

If your endoscopy and colonoscopy were both clear and your haemoglobin keeps falling, the bleeding is in the six metres between them. That segment has its own investigation.

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OverviewDiagnostic and therapeutic investigation of bleeding from the small intestine — the segment invisible to standard endoscopy and colonoscopy — using capsule endoscopy or balloon enteroscopy.
Who needs itUnexplained iron-deficiency anaemia, recurrent blood in stool, or occult bleeding where both upper endoscopy and colonoscopy have returned normal.
ProcedureCapsule endoscopy (a swallowed camera) for diagnosis; balloon-assisted enteroscopy to both find and treat — stopping bleeding, removing polyps, taking biopsies.
LocationBalloon enteroscopy at Innocent Hearts Hospital. Capsule endoscopy interpretation and consultation at GastroNova Clinic.
Capsule: swallowed, no sedation Enteroscopy treats what it finds Rare expertise in Punjab Avoids exploratory surgery
When It Is Needed

Who Needs the Small Bowel Investigated

This investigation is almost always the third step, not the first. It follows two normal scopes and a problem that has not gone away.

Haemoglobin that keeps dropping

Recurrent iron-deficiency anaemia with no source found on upper endoscopy or colonoscopy points to the small bowel by elimination.

Repeated blood transfusions

If you are being transfused periodically with no explanation, the source has to be found rather than managed around.

Occult blood in stool, normal scopes

A positive faecal occult blood test with two clear scopes leaves one place left to look.

Suspected angiodysplasia

Fragile abnormal vessels in the small bowel are a common cause of slow, invisible blood loss, particularly in older patients.

Suspected small bowel Crohn’s

Disease confined to the small bowel is missed by both standard scopes. More on IBD.

Suspected small bowel tumour

Uncommon, easily missed, and far more treatable when found early rather than at obstruction.

Your Visit

How the Small Bowel Is Investigated

A staged approach: confirm the obvious places are clear, find the lesion, then go back and treat it.

First

Rule out the reachable

  • Clinical assessment, iron studies and haemoglobin trend reviewed
  • Upper endoscopy and colonoscopy confirmed normal
  • Previous reports reviewed rather than repeated unnecessarily
  • CT enterography or angiography where the bleeding is brisk
Then

Capsule endoscopy

  • A camera capsule is swallowed — no sedation, no scope
  • It photographs the entire small bowel as it passes
  • Images reviewed by Dr. Ankit to localise the lesion
  • The capsule passes naturally; retained capsules are retrieved endoscopically
Finally

Balloon enteroscopy

  • The scope goes back to the segment the capsule identified
  • Bleeding coagulated, polyps removed, biopsies taken
  • Done under sedation or general anaesthesia at Innocent Hearts
  • Structured follow-up with repeat haemoglobin monitoring
The Two Tools

Capsule Finds It, Enteroscopy Treats It

They are complementary, not alternatives. The capsule is the map; the enteroscope is the treatment.

Small bowel capsule endoscopy in Jalandhar Capsule endoscopySwallowed camera, no sedation
Small bowel bleeding source identification in Jalandhar Locating the sourceAngiodysplasia, ulcers, tumours
Balloon enteroscopy at Innocent Hearts Hospital Jalandhar Balloon enteroscopyReaches and treats the lesion
What Gets Treated

What Balloon Enteroscopy Can Do Once It Arrives

The reason for going to the trouble of deep access is that treatment happens in the same session.

Angiodysplasia coagulation

Argon plasma coagulation seals the fragile abnormal vessels that cause most obscure small bowel bleeding.

Ulcer haemostasis

Clips or injection therapy applied to a bleeding small bowel ulcer.

Polyp removal

Small bowel polyps snared endoscopically instead of through an operation.

Deep biopsy

Tissue taken from lesions no other test can reach, confirming Crohn’s, coeliac or tumour.

Stricture dilation

Narrowed segments dilated, often preventing a bowel resection.

Retained capsule retrieval

A capsule stuck behind a stricture recovered endoscopically rather than surgically.

Do not settle for "we could not find anything"

If your haemoglobin keeps falling and both scopes were normal, the investigation is incomplete — not finished. Continuing without an answer means repeated transfusions and a missed diagnosis such as angiodysplasia, small bowel Crohn’s or a tumour. Bring both previous reports to the consultation so nothing is repeated unnecessarily.

Where It Is Done

Where Each Part Is Done

Capsule endoscopy is arranged and read at the clinic; balloon enteroscopy is done at the hospital.

Procedure centre

Innocent Hearts Hospital

Balloon enteroscopy and therapeutic small bowel work
Near Wadala Chowk, Nakodar Road, Jalandhar 144003
  • Procedure timings
  • Mon–Sat10:00 am – 5:00 pm
  • Gastro ICU24 / 7
Book This Procedure Directions
A note on scope

Anaemia from blood loss needs the bleed stopped, not a supplement

Patients with long-standing anaemia often arrive asking which protein or tonic will help. The honest answer is that none of them will, because the problem is ongoing blood loss — the treatment is finding and coagulating the lesion, plus iron replacement. Hepatolean Advance Liver Pro+, the sugar-free liver-care protein Dr. Ankit formulated, is for fatty liver patients and has no role here. It is mentioned so the question is answered rather than left hanging.

What it actually is
Patient FAQs

Small Intestinal Bleeding — Frequently Asked Questions

Why can't a normal endoscopy find it?
Upper endoscopy reaches the duodenum and colonoscopy reaches the last part of the small bowel from below. Roughly six metres in between is beyond both, and that is where obscure GI bleeding hides.
What is capsule endoscopy like?
You swallow a camera the size of a large tablet. It photographs the small bowel as it passes and is excreted naturally. No sedation, no scope, and you go about your day while it works.
If the capsule finds the bleeding, why do I need enteroscopy too?
Because a capsule can only look. Enteroscopy goes back to the same segment and coagulates the vessel, removes the polyp or takes the biopsy.
What usually causes it?
Angiodysplasia — fragile abnormal vessels — is the commonest cause, especially in older patients. Small bowel ulcers, Crohn’s disease and tumours account for most of the rest.
Can the capsule get stuck?
Rarely, and usually only where there is an undiagnosed stricture. If it happens, it is retrieved endoscopically during the enteroscopy rather than surgically.
Will I need surgery?
Usually not. That is the entire point of this pathway — balloon enteroscopy treats most small bowel bleeding lesions endoscopically, avoiding exploratory surgery.

Two Normal Scopes and Still Anaemic?

Bring both reports and your haemoglobin trend to an OPD consultation at GastroNova Clinic. The small bowel is the next place to look.

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