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What is a Double Balloon Endoscopy?

By Jami Yontz
Updated May 17, 2024
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A double balloon endoscopy is a procedure that a physician uses to examine the small intestine. During the procedure, a tube with two attached balloons is inserted through the mouth or rectum. One balloon is attached the overtube, a tube that contains a small light and camera used to view the length of the bowel. The other balloon is attached to the top of the endoscope. With this type of procedure, the physician will not only be able to examine the patient’s small bowel, but he or she will also be able to biopsy tissue from the lining of the intestine and remove tumors or growths.

Before the procedure, the person must abstain from food or drink for eight hours. A treatment of oral laxatives may be prescribed for the day prior to the procedure to rid the bowel of any contents. The person should also not take aspirin for a few days prior to the exam, and he or she should provide the physician with a list of all medications he or she is currently taking. A patient must arrive at least one hour before the procedure is scheduled to be performed, and the test usually takes one to three hours to complete. General anesthesia or sedation is given to the patient, so he or she will need to contact a friend or family member who is able to drive the person home from the hospital.

During a double balloon endoscopy, otherwise known as push-and-pull enteroscopy, the endoscope is advanced through the small bowel by alternating the inflation of each balloon. The balloons help to further the passage of the scope by anchoring the tube, and they also are able to straighten the small bowel for better visualization. A double balloon endoscopy is usually performed if abnormalities have been detected during a computed tomography (CT) or enteroclysis scan.

The double balloon endoscopy procedure was invented in Japan. Before this procedure became available, it was difficult for a physician to be able to view the full 25 feet (7.62 meters) of the small bowel. A colonoscopy can only go so far into the length of the small bowel, and the capsule endoscopy provided sporadic images from the length of the gastrointestinal tract.

This procedure allows the physician to treat internal bleeding in the bowel, while other types of endoscope exams do not. Polyps and cancerous tissue can also be removed during a double balloon endoscopy, and a feeding tube is sometimes inserted during the exam. To prepare for a surgical procedure, the physician may mark the area that requires attention, preventing invasive searching of the location of the problem that would have otherwise been necessary.

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