What is single or double balloon enteroscopy and why is it performed?

Ballon enteroscopy allows your doctor to potentially examine the lining of the entire small bowel. The most common reason for doing a balloon enteroscopy is to identify and possibly treat abnormalities of the small bowel discovered with capsule endoscopy or other tests.

Your doctor will use a thin, flexible tube called an enteroscope, which has its own lens and light source, and will view the images on a video monitor. Ballon enteroscopy may be undertaken from the mouth or the anus dependent on the location of the pathology that is to be reached. Below is a brief video discussing the procedure.

What preparations are required?

An empty stomach/small bowel is required for a thorough and safe baloon enteroscopy examination of the upper gastrointestinal tract. Specific details about how to prepare for balloon enteroscopy of the upper gastrointestinal tract can be found here.

Specific details about how to prepare for balloon enteroscopy of the lower gastrointestinal tract can be found here. Some medications may need to be discontinued before balloon enteroscopy.

What happens during balloon enteroscopy?

Your doctor will first discuss the risks of the procedure with you and address any questions you may have. You will then meet your anaesthetist who will discuss all aspects of the anaesthetic. Following this you will be taken to the procedure room. You'll then lie on your side, and a needle will be placed in your hand or arm. This is used to administer the anaesthetic. Once you are completely asleep your doctor will pass the enteroscope through the mouth or the anus dependent on whether the upper or lower gastrointestinal tract is to be examined. The procedure usually takes around 60-90 minutes.

What happens after balloon enteroscopy?

You will be monitored until the anaesthetic has worn off. Your doctor will explain the results of the examination to you and will provide you with a written report of your procedure for your GP. You will be able to eat after you leave unless your doctor instructs you otherwise. Because of the anaesthetic, your judgement and reaction time will be impaired for the rest of the day. You will need someone to drive you home and stay with you.

What are the possible complications of balloon enteroscopy?

Complications after balloon enteroscopy are rare. The most serious complication is perforation (a hole or tear in the gastrointestinal tract wall) and this routinely needs surgery. Balloon enteroscopy of the upper gastrointestinal tract carries a 1 in 200 risk of pancreatitis. This usually manifests as abdominal pain and usually settles with a period of bowel rest/fasting for 24-48 hours. Pancreatitis may occasionally require admission to hospital and rarely may lead to life threatening complications.

Other risks include bleeding from a biopsy site or polyp removal site. This is uncommon however it may lead to transfusion or admission to hospital. Some patients may have a reaction to the anaesthetic or complications from heart or lung disease.

Although complications after balloon enteroscopy are uncommon, it's important to recognise complications and treat them early.

Contact your doctor immediately if you have a fever after the test or if you have abdominal pain, or bleeding, including black stools. Bleeding can up to two weeks after the procedure. If you have any concerns following your test, you should contact your doctor right away.