To the patient:

Your physician has determined that flexible Double Balloon Endoscopy™ is necessary for further evaluation or treatment of your condition. This brochure has been prepared to help you understand the procedure including answers to “most frequently asked” questions by patients.

Please read this brochure carefully. If you have additional questions, please feel free to discuss them with the endoscopy nurse or your physician before the examination begins.

What is Double Balloon Endoscopy?

Double Balloon Endoscopy is a procedure that enables your physician to examine the small intestine by slowly advancing a flexible endoscope with a tube on it (about the thickness of your finger) throughout the small bowel. The endoscope may be inserted orally or rectally to give the physician the best access to the intestine.

Until recently, it was difficult for doctors to examine the small intestine. A new type of enteroscope created by Fujinon Inc. called the Double Balloon Enteroscope means it is now possible to examine much further into the small bowel and in some cases offer treatment. The Double Balloon Enteroscope enables the endoscopist to:

• Visualize the small intestine
• Remove tissue for biopsy 
• Remove small tumors and abnormal growths (eg: polyps) 
• Treat bleeding problems 
• Dilate strictures

How do I prepare for the procedure?

The intestine must be completely empty of waste material for the procedure to be accurate and complete. You will be asked not to consume any food or liquids after midnight prior to your examination. If the procedure is to be performed rectally your physician will likely give you an oral laxative and detailed instructions regarding preparation.

What happens when I arrive at the hospital?

You should plan to arrive about an hour before the scheduled time of the examination. Wear loose fitting, comfortable clothing, and leave all jewelry and valuables at home. A staff member will review your medical history and compile a list of all medicines you are taking for your chart. A Double Balloon Endoscopy may be performed under general anesthesia. If so, you will meet the anesthesiologist who will answer any questions you may have.

What about my current medicines?

Most medications can be continued as usual, however, use of aspirin, anti-coagulants (blood thinners) and herbal dietary supplements should be discussed with your physician prior to the examination.

What can be expected during Double Balloon Endoscopy?

Double Balloon Endoscopy is usually well-tolerated and rarely causes much discomfort. You will be sedated and unaware of the procedure. You will be lying on your side as the small intestine is carefully examined. The procedure usually takes about 1.5 hours.

What if the exam shows something abnormal?

If the doctor sees an area that needs evaluation in greater detail, a biopsy may be obtained and submitted to a laboratory for analysis.

What happens after the examination?

After the examination, you will be moved to the recovery room, where you will stay for about two hours. At first you will be very drowsy or sleepy. You may feel some mild cramping from air that has remained in the intestine during the examination. This will dissipate as air is released from your body.

In some instances, your physicians may want you to stay for a longer observation period. Once you leave the hospital, you should be able to resume normal activities within a day or two.

What are the possible complications of Double Balloon Endoscopy?

Double Balloon Endoscopy and biopsy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures. Possible complications include a perforation (tear through the bowel wall) and bleeding from the site of the biopsy.

Although complications after this procedure are rare, it is important for you to recognize early signs of possible complications. Contact your physician if you notice any of the following symptoms: severe abdominal pain, fever and / or chills. It is important to note that some bleeding can occur even several days after a biopsy.