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New Endoscopic Method for Accessing the Small Bowel

In Deep: Single-Balloon Enteroscopy at the MUSC Digestive Disease Center

The MUSC Digestive Disease Center (DDC) is the first in South Carolina to offer single-balloon enteroscopy (SBE), a form of deep enteroscopy that enables the endoscopist to explore much further into the small intestine than would be possible with traditional endoscopy. It offers a cost-effective and minimally invasive way to identify the source of occult gastrointestinal (GI) bleeding, to biopsy and/or remove small bowel polyps, to determine whether a tumor is malignant, to retrieve foreign objects (ie, retained video capsules), and to explore other small bowel abnormalities. It also provides a much-needed nonsurgical means for inserting feeding tubes in patients with Roux-en-y anatomy.

"A major advantage of single-balloon enteroscopy is that it often allows for both diagnosis and treatment of a small bowel abnormality during the same endoscopic session, whereas most other modalities for the small intestine are diagnostic only,"; according to Andrew Brock, M.D., a gastroenterologist at the DDC who performs eight to ten SBE per month for a career total of well over 250. Because it can reach the deeper bowel, SBE can be used to diagnose abnormalities much earlier when they are more amenable to treatment, reducing the number of blood transfusions and/or hospitalizations required by patients with occult bleeding disorders.

Candidates for SBE are often identified via capsule endoscopy (CE), which involves the swallowing of a capsule containing a tiny camera that takes tens of thousands of pictures as it passes through the GI tract. Developed in tandem with CE in the early 2000s, SBE was intended to be used to treat CE-identified abnormalities. CE was more quickly adopted by clinicians, but its potential is only now being realized with the greater availability of SBE.

Dr. Brock sees SBE as an important step forward in the treatment of patients with occult GI disorders and is pleased to be able to offer such cutting-edge technology to South Carolinians: "As small bowel endoscopic technology continues to improve, I hope that we can offer patients more and more safe and effective ways to treat problems that traditionally have been out of our reach."