Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
The use of upper and lower gastrointestinal endoscopes has revolutionized the diagnosis and treatment of diseases of the esophagus, stomach, duodenum, and colon (large intestine). The last remaining frontier in the intestines has been the small intestine. Wireless capsule endoscopy allows physicians to visualize the inside of the intestines from the esophagus through to the colon, but capsule endoscopy has limitations, the most notable of which are the inability to control the capsule's passage and to perform therapy,
such as biopsy and electrocautery. Although capsule endoscopy is likely to remain an important diagnostic procedure because of its simplicity, the limitations of capsule endoscopy have been overcome by the development of balloon endoscopy, also known as enteroscopy.
What is balloon endoscopy?
There are two types of balloon endoscopy: single balloon and double balloon.
Single balloon endoscopy
For single balloon endoscopy, a 200 cm long flexible, fiberoptic, endoscope (a hose-like tube one centimeter in diameter with a light and a camera on the tip) is fitted with an equally long overtube that slides the full length of the endoscope. On the tip of the overtube is a balloon that can be blown up and deflated. The balloon when blown up is used to anchor the overtube within the intestine. While the overtube is anchored, the endoscopy can be advance further into the small intestine. By withdrawing the overtube the small intestine can be shortened and straightened to make the passage of the inner endoscope easier. The balloon may then be deflated so that the overtube can be inserted further and the endoscope advanced again.The endoscope itself is a standard endoscope with working channels that allow the intestine to be inflated with air, rinsed with water, or to guide biopsy or electrocautery instruments to the tip of the endoscope.
Standard upper gastrointestinal endoscopes (120 cm flexible tubes with a light and camera on their tips) are capable of reaching only a foot or so past the stomach into the small intestine. If abnormalities are locate"...