How to prepare for balloon enteroscopy

To prepare for a balloon enteroscopy, you need to stop solid food for eight hours or more. You may need to stop blood thinners up to 7 days before the test. You can take your essential medications like those for blood pressure the morning of your test. There are 2 types of balloon enteroscopies: upper GI balloon enteroscopy (antegrade) and lower GI balloon enteroscopy (retrograde). Also, two types of balloons exist – single balloon and double balloon.

What is a balloon enteroscopy?

The enteroscope (endoscope) is a flexible tube with light and camera at the end. It is longer than the gastroscope. The small intestine is about 20 feet long and very floppy. It is difficult to navigate the small intestine with a regular endoscope due to its length and floppiness.

To solve this problem, an over-tube with balloon is attached to the endoscope and the small intestine is pleated over the over-tube.  Single balloon has one balloon while double balloon has 2 balloons.

The balloon system consists of a 200 cm endoscope and an over-tube. One or two inflatable balloons are attached to the over-tube. The balloon or balloons are inflated and deflated thereby gripping the wall of the small bowel. The over-tube is pushed forward and backward.

These technique pleats the small bowel over the over-tube (like a curtain over a rod) and moves the endoscope forward.

Fluoroscopy (use of X-ray) may be used during the procedure.

Why do you need a balloon enteroscopy?

  • Abnormal capsule endoscopy with abnormalities in the small intestine.
  • Evaluate iron deficiency anemia.
  • Abnormal CT scan or MRI with abnormalities in the small intestine.
  • Diagnose cancer of the small intestine.
  • Treat bleeding from the small intestine from things like ulcer, inflammation, abnormal blood vessels, cancer.
  • Relieve obstruction in the small intestine.
  • Evaluate and treat polyps in the small intestine especially in patients with polyposis syndromes.
  • Remove foreign body in the small intestine.
  • Evaluate and treat complications of Crohn’s disease.

 

What are the risks of balloon enteroscopy

Risks of balloon enteroscopy include reaction to sedation, breathing problems, nausea, vomiting, abdominal pain, headaches, heart problems, bleeding, perforation, pancreatitis, ileus and death.

The risks and benefits are discussed during consent before the test.

What are the alternatives to a balloon enteroscopy

Special X-ray, CT scan, MRI, capsule endoscopy, medications, surgery and interventional radiology procedures like embolization are alternatives depending on the circumstances.

How do I prepare for my test

What do I do 1 week before the balloon enteroscopy?

  • Discuss all your medications with your provider.
  • You may need to stop your antiplatelet or anticoagulants such as Coumadin, Plavix.
  • You may continue to take your aspirin.
  • Arrange for a driver to take you home after the procedure.

What do I do 2-3 days before the balloon enteroscopy?

  • You may need to stop anticoagulants like Eliquis, Pradaxa, and Xarelto 2-3 days before your balloon enteroscopy.
  • For lower GI balloon enteroscopy, follow diet instructions given for colonoscopy.

What do I do a day before the balloon enteroscopy?

  • Confirm your transportation with a responsible adult driver.
  • No solid food 8 hours prior to your procedure.
  • For lower GI balloon enteroscopy, follow instructions on how to use your bowel cleansing agent.

What do I do on the day of the balloon enteroscopy?

  • You may take your essential morning medications with a few small sips of water, at least 4 hours before your procedure, unless as directed by your physician.
  • Nothing by mouth at least 4 hours prior to your procedure including gum, hard candies, mints, tobacco.
  • For lower GI balloon enteroscopy, follow instructions on how to use your bowel cleansing agent.
  • Leave your valuables at home.
  • Bring your ID, insurance cards, and any co-pay with you.

 

What to expect during the procedure

You will be given medicines to make you sleepy. Most people do not remember the test. You will be given oxygen and monitored throughout the test.

Your doctor will insert the endoscope through your mouth (or rectum for lower GI balloon enteroscopy) and examine the lining of your small intestine.

Other tools be may passed into your small intestine via the endoscope. For most people, the procedure lasts about 1-2 hours.

What to expect after the procedure

You will be monitored until you are awake. You may eat or drink once you are awake. Your doctor may discuss your result with you and whomever came with you.

You may be given a copy of your report. If biopsies are taken, it may take a few days for those results to come from the pathologist.

Someone should drive you home.

 

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