Name of the Procedure:

Colonoscopy, flexible; with transendoscopic balloon dilation
Common Name: Flexible colonoscopy with balloon dilation

Summary

A flexible colonoscopy with balloon dilation is a medical procedure where a flexible tube with a camera (endoscope) is inserted into the colon to examine its lining, detect any abnormalities, and widen narrowed sections using a balloon.

Purpose

This procedure addresses conditions causing bowel obstructions or strictures, such as Crohn's disease, scar tissue, or benign/malignant tumors. The goal is to relieve symptoms like abdominal pain and bowel movement difficulties, allowing normal passage of stool.

Indications

• Persistent abdominal pain
• Chronic constipation or bowel obstruction
• Evidence of strictures from imaging studies
• History of inflammatory bowel disease, previous surgeries, or radiation therapy

Preparation

• Fasting for 12 hours before the procedure
• A bowel prep regimen involving laxatives to clear the colon
• Temporary discontinuation of certain medications as advised by the doctor
• Blood tests to check clotting function, if necessary

Procedure Description

1. The patient is sedated for comfort.
2. A flexible colonoscope is gently inserted through the anus into the colon.
3. The colonoscope transmits images to a monitor, allowing the doctor to inspect the colon lining.
4. Upon identifying a stricture, a balloon catheter is passed through the colonoscope to the affected area.
5. The balloon is then carefully inflated to stretch the narrowed section of the colon.
6. The balloon is deflated and removed, and the colon is re-examined to confirm successful dilation.
7. The colonoscope is withdrawn, completing the procedure.

Duration

Typically lasts 30 minutes to 1 hour.

Setting

Performed in a hospital, outpatient clinic, or surgical center with appropriate endoscopic facilities.

Personnel

• Gastroenterologist or endoscopic surgeon
• Nurses for assistance and monitoring
• Anesthesiologist or nurse anesthetist for sedation

Risks and Complications

• Common: Mild discomfort, bloating, minor bleeding
• Rare: Perforation of the colon, severe bleeding, infection, adverse reaction to sedation Management includes observation, medication, or rarely, emergency surgery.

Benefits

• Relief from obstructive symptoms
• Improved bowel movement
• Enhanced quality of life Benefits are typically realized soon after the procedure, with most patients experiencing significant symptom relief.

Recovery

• Post-procedure monitoring until sedation wears off
• Instructions on diet and activity; usually minor restrictions
• Typically, a follow-up appointment with the treating physician Recovery duration is usually 24-48 hours, with most patients returning to normal activities shortly after.

Alternatives

• Medication management (less invasive but possibly less effective)
• Surgical resection (more invasive, longer recovery but potentially more definitive)
• Endoscopic stenting (another minimally invasive option, may have different risks and benefits)

Patient Experience

Patients might feel slight discomfort during sedation, and some bloating or mild cramps post-procedure. Pain management includes sedatives during the procedure and over-the-counter pain relievers if needed afterward. Comfort measures such as warm packs may be recommended for post-procedure gas and cramps.