Which type of endoscopy is especially beneficial for deep small bowel examination?

The optimal choice for a deep small bowel examination is double-balloon enteroscopy. This technique is particularly beneficial because it employs a specialized approach that allows for the examination and intervention in the deeper segments of the small intestine, which would be difficult to access with other methods.

Double-balloon enteroscopy uses a system of balloons on the endoscope and a companion overtube, allowing for better advancement through the small bowel by anchoring the endoscope in place and then advancing it further, thus facilitating access to areas that are typically challenging to visualize. It can also enable therapeutic interventions, such as biopsies or polypectomies, in the distal small bowel.

In contrast, esophagogastroduodenoscopy (EGD) primarily targets the esophagus, stomach, and duodenum, making it unsuitable for deep small bowel examination. Capsule endoscopy offers visualization but lacks the ability to perform interventions, which limits its utility in certain diagnostic scenarios. Peroral endoscopic myotomy (POEM) is focused on performing myotomy procedures for conditions like achalasia and is not intended for deep small bowel evaluation. Therefore, double-balloon enteroscopy stands out as the most effective option for such examinations.