Gastrointestinal bleeding originating from the small bowel is difficult to diagnose and
treat because the small bowel is difficult to see and reach. Balloon assisted enteroscopy
(BAE) is a new enteroscopy methods that allow examination of the small bowel and allows for
diagnosis and treatment of bleeding originating from this part of the intestine.
Unfortunately, BAE is unsuccessful in identifying the cause of bleeding in 40-50% of
patients. This may be due to limited visualization of the small bowel lining during
conventional endoscopy. One way to improve visualization of the small bowel lining is by
adding a transparent plastic cap to the end of the endoscope (camera), which allows the
endoscope to see around sharp turned and behind folds in the small bowel.
The investigators goal in this randomized controlled study is to see if adding a transparent
cap to the end of the endoscope will help to identify and treat small bowel bleeding. The
investigators will invite patients referred for BAE to participate in the study; the
alternative to participating in the study is having standard BAE (without a cap). If
patients choose to participate in the study they will be randomized to BAE with or without a
cap on the end of the endoscope. Subjects time commitment will be limited to the consent
process and pre-procedure paperwork at time of initial endoscopy and time required to
complete telephone questionnaire at 12 months follow up.
- Adult (≥18 years old) patients undergoing BAE for the evaluation of OGIB or iron
- Unable to provide written informed consent.
- Pregnancy or lactation.
- Suspected bowel obstruction or GI perforation.
- Unable to tolerate sedation or general anesthesia due to medical co-morbidities.
- Uncorrected coagulopathy (platelet count <50,000, INR> 2, PTT> 2x upper limit of
- Patient undergoing retrograde BAE.