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Balloon Assisted Enteroscopy

What is a Balloon-assisted enteroscopy?

Balloon-assisted enteroscopy is an incisionless procedure performed to reach and treat less-accessible colon polyps or areas of bleeding in the gastrointestinal (GI) tract. During the procedure, gastroenterologists (physicians who specialize in treating the GI tract) use flexible, tube-like imaging instruments (endoscopes) to see the area of the body being treated.

Balloon-assisted enteroscopy uses endoscopes equipped with balloons that inflate and deflate to pinch together the walls of the GI tract. By compressing the walls, the gastroenterologist can reach and treat less accessible areas. The enteroscopy may be done as an inpatient or outpatient procedure. Eligible patients can avoid surgery and may recover faster.

Johns Hopkins gastroenterologist Dr. Kathy Bull-Henry answers frequently asked questions regarding the double balloon enteroscopy.

Balloon-Assisted Enteroscopy: Why It’s Performed

Physicians use balloon-assisted enteroscopy for conditions affecting both the upper GI tract and the lower GI tract. This procedure can effectively provide access to the small bowel (small intestines). The small bowel is very long, which makes it difficult to access using other procedures.

Balloon-assisted enteroscopy may allow our gastroenterologists to:

  • Identify and treat the source of GI bleeding.
  • Take tissue samples to examine for a laboratory diagnosis (biopsy).
  • Remove small bowel polyps or a foreign object.
  • Enlarge a narrowed pathway (stricture) in the upper or lower GI tract.

Our team may use balloon-assisted enteroscopy along with capsule endoscopy or imaging scans to get a better view of the area needing treatment.

Balloon-Assisted Enteroscopy: How to Prepare

Before your procedure:

  • For a lower GI tract procedure, follow a liquid diet plus a laxative or enema to cleanse the bowel.
  • For an upper GI tract procedure, do not eat or drink for 12 hours before the procedure to clear your esophagus of any food products.
  • Tell your doctor if you have any allergies.
  • Follow your doctor’s instructions about whether to take your prescription medications.

Balloon-Assisted Enteroscopy: What to Expect

On the day of your procedure, plan to arrive at the endoscopy unit at least three hours before the procedure. You will register and provide your medical history, including any medications you have taken. A responsible driver must be available to drive you home.

During the procedure, your gastroenterologist will:

  • Put an IV into your vein to deliver either a sedative that will make you drowsy or anesthesia that will put you to sleep.
  • Insert a high-definition endoscope with an outer sleeve into the small bowel through your anus. Your doctor will observe the images on a screen. Doctors may use X-ray guidance to advance the scope.
  • Use an attached balloon that inflates and deflates in succession to grip the walls of the intestine. This allows your doctor to reach the area requiring diagnosis or treatment. As the balloon inflates and deflates, the wall of the small intestine pleats together over the outer tube of the endoscope (similar to how a curtain pleats over a rod) and shortens.
  • Use tools such as forceps, dilation devices or cautery (heat conduction) probes to treat the deep part of the small bowel that is now accessible.
When the procedure is complete, we will track your recovery while the effects of the sedative or anesthesia wear off. Your doctor will discuss your results with you before you leave.
Common side effects may include:
  • Sore throat
  • Nausea or vomiting
  • Excessive gas, bloating or cramping