What is a balloon-assisted enteroscopy?

Balloon-assisted enteroscopy is an endoscopic procedure which allows your Gastroenterologist to examine and perform interventions (i.e. treat bleeding, remove polyps) within parts of the small bowel which are beyond the reach of routine gastroscopy and colonoscopy. Single-balloon and double-balloon enteroscopy can be used with similar efficacy.

How do I prepare?

The preparation for balloon-assisted enteroscopy will be determined by whether your procedure is performed via an oral or anal approach. Your Gastroenterologist will provide you with specific preparation instructions.  

An empty stomach is essential for a safe procedure, so you should have nothing to eat for six hours beforehand. You can continue to drink ‘clear fluids’ only (i.e. water, clear fruit juice without pulp, cordial, black tea/coffee WITHOUT milk, Gatorade/sports drinks, soft drinks) up until two hours prior to your procedure. After that you must remain nil by mouth apart from a sip of water with any important regular medicines (but do not take any diabetes medications). Patients taking diabetic or blood thinning medications should inform their Gastroenterologist as they may require specific instructions.

How is a balloon-assisted enteroscopy performed?

Balloon-assisted enteroscopy is performed under deep sedation or general anaesthesia. Once sedated and lying in a comfortable position on your left side, the enteroscope is passed orally or anally depending on the indication for your procedure. The enteroscope is passed through a flexible plastic overtube with an inflatable balloon at its distal end which enables pleating of the small bowel onto the overtube and subsequent deep small bowel insertion.  A camera at the end of the scope transmits a video image to a monitor, allowing the Gastroenterologist to carefully examine the lining of your small intestine and perform interventions if necessary. The procedure usually takes approximately 60-90 minutes to complete.

What happens after a balloon-assisted enteroscopy?

Following the procedure, you will remain in the recovery area for an hour or so until the sedation medication wears off. Your Gastroenterologist will briefly inform you of your test results on the day of the procedure and if necessary, a follow-up appointment may be made to discuss the test results in more detail. 

Because of the sedation medication given during the procedure, it is very important that you do not drive a car, travel on public transport alone, operate machinery, sign legal documents or drink alcohol within the first 24 hours after the procedure. After 24 hours you can return to work and resume normal activities. It is mandatory that a responsible adult accompanies you home and stays with you overnight.

What are the risks or side-effects?

Although complications can occur with any procedure, they are infrequent after balloon-assisted enteroscopy. Common side-effects may include abdominal discomfort which should resolve within an hour or so. Significant complications may include pancreatitis (0.3% of cases), perforation (hole in the wall of the gastrointestinal tract) (0.2%), bleeding (0.2%), and aspiration pneumonia (1%). Surgery may be required to repair a perforation. The rate of complications may be higher for patients undergoing therapeutic procedures such as polypectomy or stricture dilatation. Like all medical procedures, there is a remote chance that significant complications can result in death, however this is exceedingly rare.