Single or Double Balloon Enteroscopy

What is balloon enteroscopy?

Balloon enteroscopy lets your healthcare provider look inside small intestine and treat any issues they find. It’s a type of deep enteroscopy. That means using a specialized scope to reach deep into your small intestine. Conventional upper GI endoscopes only reach the upper part of it (the duodenum).

These procedures use one or two balloons that inflate and deflate to help advance the endoscope. The double balloon enteroscopy was the first device-assisted enteroscopy that allowed a provider to both view and treat the entire small intestine. The single balloon enteroscopy is a newer variation.

Why might I need a balloon enteroscopy?

If your healthcare provider has recommended a single or double balloon enteroscopy, it’s probably because they already suspect you have a condition that needs further investigation or treatment. The most common reason is to find and treat bleeding. Other reasons include finding and treating:

• Crohn’s disease
• Objects stuck in your intestine
• Polyps, tumors or other lesions
• Stricture

Types of enteroscopy

• Double balloon enteroscopy: The double balloon enteroscope has a unique, tube-within-a-tube design. The inner tube has a light and a camera on it. The outer tube expands your intestinal walls so the camera can see them. Each tube has its own balloon at the head. A healthcare provider advances the tubes one at a time by inflating and deflating each balloon in turn.
• Single balloon enteroscopy: The single balloon enteroscope is a newer variation on the same theme. It has an inner tube and an outer tube, but only the outer tube has a balloon. The inner tube has a flexible tip that bends to anchor it in place, taking the place of the second balloon. This method is a little faster, but it hasn’t been as widely adopted as the double balloon method.

Do I need to prepare for a balloon enteroscopy?

You’ll need to make sure your small intestine is empty for the procedure to be successful. This means you’ll be on a clear liquid diet for a day or two. Your healthcare provider will provide instructions.

If the scope will enter through your anus (butthole), you may need a bowel prep. This is similar to what you’d do for a colonoscopy. You’ll take laxatives to help clean out your intestines.

What happens during a single or double balloon enteroscopy?

You’ll have general anesthesia or sedation for the procedure, so you can sleep through it. Your provider will pass the enteroscope through your (top-down) throat or through your rectum (bottom up). Once it’s in, they’ll repeatedly inflate and deflate the balloon(s). Each time, the scope advances a short distance.

The scope will transmit images to a screen as it goes. Your provider will inspect each section. They can use special tools to treat problems through the enteroscope. During your procedure, they might:

• Find and treat the source of intestinal bleeding
• Remove a tumor or obstruction
• Screen you for small intestine cancer
• Check for conditions like Crohn’s disease or celiac disease
• Place a stent or widen (dilate) a narrowed passage
• Take a tissue sample to send to a lab (biopsy)

Enteroscopy may take up to several hours, depending on how far they go and the treatment you need.

What are the potential risks and benefits of the procedure?

Having an enteroscopy allows you to avoid the more significant risks and recovery that come with having surgery on your small bowel. This is especially helpful if you need to repeat exams over time.

Serious complications from balloon enteroscopy are rare. That said, all procedures carry some risk. One risk of enteroscopy is that the enteroscope could injure or tear your small intestine.

Another risk is pancreatitis, an inflammatory condition of the pancreas.

What happens after balloon enteroscopy?

After balloon enteroscopy, it may take an hour or two to fully wake up from the anesthesia. Once you’re awake, your provider will explain what they found and what they did during the procedure.

Most people only experience mild discomfort after the procedure. If you had an upper enteroscopy, your throat might be sore. If you had a lower enteroscopy, you might have some intestinal gas.

You should feel better in a couple of days. You can go home the same day. But the anesthesia may continue to affect you for 24 hours. So, you’ll need to arrange for someone else to drive you home.

If they took a tissue sample during the procedure, it may take a week to get the lab results back.