Double Balloon Enteroscopy
DOUBLE BALLOON ENTEROSCOPY (DBE)
What is Double balloon enteroscopy (DBE)?
DBE is a test which enables your doctor to examine the inside of the small intestine with the help of an instrument called enteroscope. Until recently it was difficult for the doctors to examine very far into the small intestine, only limited assessment was possible with the push enteroscope. Now due to availabilty of the double balloon enteroscope it is possible to examine the inside of the whole small intestine either through single or combination of 2 approaches (oralandanal).
Why is DBE done?
To investigate the cause of obscure GI bleeding , recurrent iron deficiency anaemia and disorders involving the sm all intestine.
What Preparation is Required?
The stomach must be completely empty for the oral approach You should have nothing to eat or drink, including water, for approximately 6 hours before the examination. If using the anal approach will need to take bowel preparation. Your doctor will be more specific about the time to begin fasting, or need for bowel prep depending on the time of day that your test is arranged.
Possible Medication Adjustments
Before the test, be sure to discuss with the doctor whether you should adjust any of your usual medications before the procedure, any drug allergies you may have, and whether you have any other major diseases such as a heart or lung condition that might require special attention during the procedure.
Kindly inform your doctor of all the medication. Some medications, such as iron preparations, should be discontinued for one week before the examination. Aspirin and painkillers such as ibuprofen slightly increase the risk of bleeding. If you take a blood thinning medication, such as warfarin, clopidogrel, kindly inform your doctor , as these may need to be discontinued before the examination.
The examination :
The enteroscope can be inserted from the mouth (oral approach) or from the back passage (anal approach). This test is time consuming and procedure can take an 1hr. Sometimes we may need to use an alternative approach to visualize the entire small bowel.
The examination is performed either with a sedative injection, which will make you very relaxed and sleepy during the examination. Whilst you will appear to awake fairly rapidly after this, the medication used continues to have a mild sedative effect for up to 24hrs afterwards and this will impair your judgement.
- DO NOT drive a car
- DO NOT operate machinery(including kitchen equipment)
- DO NOT return to work
- DO NOT drink alcohol
If you have not been able to tolerate the procedure under sedtion, your doctor will discuss need for doing procedure using general anaesthetic.
What are the Possible Complications of Double balloon enteroscopy?
DBE is a safe procedure and complications are rare, but can occur:
Bleeding can occur from biopsies or the removal of polyps, but it is usually minimal.
Perforation or tear or hole in the small intestine due to insertion of the enteroscope or use of therapeutic instruments, although rare, can occur and is a serious complication.
The following symptoms should be reported immediately:
- Severe abdominal pain
- Distended abdomen