Diagnostic techniques for small intestinal disease

The factor shared by most publications about diagnostic techniques in small intestinal disease is the intent to obtain more information by less invasive means. There appear to have been few novel advances during the past year, yet increasing data to support various refinements or relatively recent innovative ideas have appeared. Methods for screening at-risk populations for celiac disease have been explored in some detail. It appears that combining serum IgA antigliadin antibodies and antiendomysial antibodies gives the best sensitivity and specificity; unfortunately, no single test seems adequate. The value of plasma postheparin diamine oxidase in assessing villus cell mass and perhaps disease is gradually being established. A combined bile salt-vitamin B₁₂ test of ileal function has been further refined. Small bowel enteroscopy has been shown to be of some value in localizing bleeding sites. An increasing body of evidence supports the value of enteroclysis in suspected small bowel obstruction. Little progress appears to have been made in clinically applicable noninvasive methods of assessing blood flow, and the past flurry of studies on the clinical value of studying intestinal permeability has slowed dramatically.