Therapeutic Balloon-Assisted Enteroscopy: Recent Advances in the Management of Small Bowel Diseases

Abstract

Balloon-assisted enteroscopy (BAE) has substantially advanced small bowel disease management. This review summarizes recent therapeutic BAE advances, focusing on three major indications: small bowel vascular lesions, hereditary polyposis syndromes, and Crohn's disease (CD). For suspected small bowel bleeding from vascular lesions, morphological classification guides lesion-specific hemostasis—primarily using argon plasma coagulation and clipping—while gel immersion endoscopy helps secure the visual field. In hereditary polyposis syndromes (e.g., Peutz–Jeghers syndrome and familial adenomatous polyposis), endoscopic ischemic and cold snare polypectomy prevent intussusception and reduce cancer risk, decreasing surgical needs. Additionally, endoscopic balloon dilation is an established bowel-preserving treatment for fibrotic CD strictures, reducing surgical resection and short bowel syndrome risk. Driven by evolving imaging and devices, BAE remains central to small bowel management, improving patient outcomes and quality of life.