Carbon dioxide insufflation improves intubation depth in double-balloon enteroscopy: a randomized, controlled,...

Area of Science:

• Gastroenterology
• Endoscopy
• Medical Devices

Background:

• Double-balloon enteroscopy (DBE) is effective for deep small bowel intubation.
• Small bowel distention from air insufflation limits intubation depth during DBE.
• Patient discomfort and pain are common after air-insufflated DBE procedures.

Purpose of the Study:

• To investigate if carbon dioxide (CO2) insufflation improves intubation depth during DBE compared to air.
• To assess the impact of CO2 insufflation on post-procedure pain and discomfort in DBE patients.

Main Methods:

• A randomized controlled trial involving 112 patients undergoing DBE.
• Patients were assigned to either CO2 or air insufflation, with blinding for patients and endoscopists.
• Intubation depth was recorded, and patient-reported pain/discomfort was measured using a visual analog scale.

Main Results:

• CO2 insufflation significantly increased mean small bowel intubation depth by 30% (230 cm vs. 177 cm).
• Oral DBE showed the most pronounced improvement with CO2, increasing depth by 71 cm.
• Patients in the CO2 group reported significantly less pain and discomfort at 1 and 3 hours post-procedure.

Conclusions:

• CO2 insufflation is superior to air for achieving greater intubation depth in DBE.
• CO2 insufflation effectively reduces patient discomfort and pain following DBE.
• The use of CO2 in DBE may enhance diagnostic and therapeutic yields while improving patient experience.