A deep understanding of whole bowel, double-balloon enteroscopy

by Dr. Abishek Rajan

A double-balloon enteroscopy is a unique and new specialized technique. Unlike the conventional push enteroscopy, with double-balloon enteroscopy, the doctors can easily complete small bowel examinations and treat previously inaccessible lesions. Furthermore, it can even enable biopsies and therapeutic treatments in every single part of the small bowel without any laparotomy. The double-ballon enteroscopy has a video endoscope that comes with two balloons: one is attached to the tip and the other is attached at the distal end of an overture.

Some of the other terms used for double-balloon enteroscopy are

  • Double Bubble
  • Push-and-pull enteroscopy.

The kinds of enteroscopy can be bifurcated into upper and lower enteroscopy. In the lower enteroscopy, the endoscope is inserted via the rectum. Whereas, in the upper enteroscopy, the endoscope is inserted through the mouth.

How is an enteroscopy performed?

With the help of double-balloon enteroscopy, it is now possible to diagnose or thoroughly examine diseases present within your body without making an incision. This procedure is commonly used to detect problems in the stomach or small intestine. Some of the best gastroenterologists in Calicut may recommend enteroscopy if you have any of the following:

  • Gastrointestinal bleeding (without any reason)
  • Tumours present in the small intestine
  • Blocked bowel passages
  • Severe diarrhoea (without any reason)
  • High count of white blood cell
  • Unexplained malnutrition
  • Alarming X-ray results
  • Intestinal damage due to radiation treatment.

How to prepare for balloon-assisted enteroscopy?

Before the procedure

  • When talking about a lower GI tract procedure, opt for a liquid diet and a laxative that will help clean the bowel
  • Then let’s come down to the GI tract procedure, it is advisable to not eat or drink for 12 hours before the procedure so that the oesophagus steers clear of any food items
  • Let the doctors of Calicut know if you have any allergies
  • Make sure to follow your doctor’s instructions about whether you need to take your prescription medications.

What are the things to expect while going through a double-balloon enteroscopy?

On the day of the surgery, try to arrive at the endoscopy at least three hours before. Once you will reach the hospital, be asked to register and provide your medical history which includes medications you are consuming. Also, ask a family member or friend to drive you back.

During your surgery, the gastroenterologist will

  • Insert the IV into the vein to give you sedatives or local anaesthesia, as that will make you feel drowsy or put you to sleep.
  • Insert the high-definition endoscope with an outer sleeve into your small bowl via the anus. The doctor will then observe the images on the screen, he/she may use X-ray guidance to advance the scope.
  • The doctors will use an attached balloon that inflates and deflates in succession to grip the walls of the intestine. This really helps the doctor reach the area that requires immediate treatment. When the balloon inflates or deflates, the wall of the small intestine will pleat together over the outer tube of the endoscope (the movement is similar to how a curtain pleats over the rod) and shortens.
  • The doctor will use tools like dilation devices, forceps, and probes that will help treat the deep part of the small that is now finally accessible.

Once you are done with the procedure, the team of medical professionals will track your recovery while the effects of the sedative or anaesthesia start to wear off. The doctors will share the results with you before you leave. Although there are some side effects which include:

  • Nausea or vomiting
  • Sore throat
  • Bloating and gas
  • Minor bleeding.

Any risks that come with enteroscopy?

The chances are less, but people may face some complications after the double-balloon enteroscopy, some of which include intestinal perforation and internal bleeding. There are some people who might react poorly to the anaesthesia. Hence, reason why enteroscopy is not recommended for pregnant women, people who are overweight, and have heart or lung disease.


Always make it a point to call your assigned doctor immediately if you experience any of the aforementioned side effects. The doctors and the care group will always take care of you even after the surgery.

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